| NPI | 1578658464 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN DAVIS LUTZ President 276-988-4549 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401006005) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2020-08-22 |