NPI | 1336461094 |
---|---|
Doing Business As | REAL LIFE DENTAL |
Entity Type | Organization |
Authorized Contact | DAMON B. THOMPSON Dentist 540-552-5433 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: VA 8616) |
Enumeration Date | 2010-02-23 |
Last Update Date | 2016-05-06 |