| NPI | 1518241215 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GROVER PRESTON BURNS President 540-737-6557 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: VA 0401410081) |
| Enumeration Date | 2011-09-29 |
| Last Update Date | 2011-09-29 |