| NPI | 1659507978 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK S. CLOTH Owner 434-964-2464 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: VA 5851) |
| Enumeration Date | 2009-06-01 |
| Last Update Date | 2009-06-01 |