| NPI | 1548699341 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYLE W. WHEELER President 434-385-6398 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: VA 0401005293) |
| Enumeration Date | 2013-11-02 |
| Last Update Date | 2013-11-02 |