| NPI | 1598905192 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD MAMRICK President 804-423-1600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: VA 0401410863) |
| Enumeration Date | 2009-02-23 |
| Last Update Date | 2009-02-23 |