| NPI | 1306398300 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSSELL N. MOSHER Dentist/Owner 804-379-6971 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401007113) |
| Enumeration Date | 2016-10-26 |
| Last Update Date | 2016-12-28 |