| NPI | 1497853758 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON S. CRIST Vice President 434-239-2651 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 8871) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2020-08-22 |