| NPI | 1588172407 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT N SORENSON Owner 434-846-8025 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: VA 401008866) |
| Enumeration Date | 2018-01-12 |
| Last Update Date | 2018-01-12 |