| NPI | 1356704258 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA ANGUS Dentist/Owner 804-729-3474 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment (Licence: VA 0401411855) |
| Enumeration Date | 2016-03-30 |
| Last Update Date | 2022-07-21 |