| NPI | 1285264887 |
|---|---|
| Doing Business As | NORTHSIDE DENTAL CO. |
| Entity Type | Organization |
| Authorized Contact | KATELIN HEIM Office Manager 804-767-3410 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental |
| Enumeration Date | 2020-01-22 |
| Last Update Date | 2020-07-21 |