| NPI | 1275315590 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA J OWENS Dentist 434-792-0700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2023-10-20 |
| Last Update Date | 2023-10-20 |