| NPI | 1619000270 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE YVONNE JOHNSONCURL President 804-264-4068 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401006645) |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2020-08-22 |