| NPI | 1396217717 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL PAGANO Owner 804-625-4066 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment | |
| Enumeration Date | 2018-12-24 |
| Last Update Date | 2018-12-24 |