| NPI | 1477722064 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER G TOMLIN Office Administrator 540-943-5211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0401008722) |
| Enumeration Date | 2008-02-27 |
| Last Update Date | 2008-02-27 |