| NPI | 1710168570 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICE HOPE MCFADDEN Business Manager 434-947-5915 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: VA 401004718) |
| Enumeration Date | 2007-11-21 |
| Last Update Date | 2007-11-21 |