NPI | 1760789796 |
---|---|
Entity Type | Organization |
Authorized Contact | JOSHUA SWANSON Owner/Dentist 540-710-1088 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401412194) |
Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
Enumeration Date | 2011-02-28 |
Last Update Date | 2024-07-10 |