| NPI | 1578587168 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HERBERT NEAL DAVIS President 276-523-2691 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401004224) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2020-08-22 |