| NPI | 1508864430 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW H CASPERSEN Vice President 540-371-2611 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0401004869) |
| Additional Taxonomies | 122300000X Dentist (Licence: VA 0401410777) |
| Enumeration Date | 2005-07-13 |
| Last Update Date | 2020-08-22 |