| NPI | 1578781571 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONNIE LEE BROWN Dentist 276-628-9507 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0401004605) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401003814) |
| 1223G0001X Dentist, General Practice (Licence: VA 0401410847) | |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2020-08-22 |