| NPI | 1710478110 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA HAWKINS HARRIS Accounts Receivable Analyst 540-776-6555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: VA 041008724) |
| Additional Taxonomies | 261QD0000X Clinic/Center Dental |
| Enumeration Date | 2018-05-22 |
| Last Update Date | 2025-06-18 |