| 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 |