| NPI | 1255683751 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | JAMES M BRONSON President 434-202-7125  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: VA 0401006161)  | 
| Enumeration Date | 2012-10-08 | 
| Last Update Date | 2012-11-20 |