| NPI | 1669665899 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA YVONNE ANDERSON Office Manager 434-973-4355 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0401410717) |
| Enumeration Date | 2007-08-21 |
| Last Update Date | 2007-08-21 |