| NPI | 1336587674 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | ANTHONY C SMALLWOOD President 304-997-0353  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401413971)  | 
| Enumeration Date | 2013-06-09 | 
| Last Update Date | 2013-06-09 |