| NPI | 1538179213 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICKI LEE TIBBS Dentist/President 804-932-4537 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 6227) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2021-08-25 |