| NPI | 1619093556 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENT EDWARD LENZ Owner 540-433-1060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: VA 0401410163) |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2020-08-22 |