| NPI | 1437379062 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMIE BLEVINS Admin Asst 540-347-2233 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401004510) |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2020-08-22 |