| NPI | 1679900542 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC MICHAEL BAUGHER President 434-385-4746 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: VA 0401414206) |
| Enumeration Date | 2013-10-08 |
| Last Update Date | 2013-10-08 |