| NPI | 1710232020 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT W BIGELOW Employee 804-741-7440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: 0401412488) |
| Enumeration Date | 2012-07-23 |
| Last Update Date | 2012-07-23 |