| NPI | 1639460504 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT A CHERON Managing Member 267-252-0125 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: VA 0401412778) |
| Enumeration Date | 2011-04-27 |
| Last Update Date | 2011-04-27 |