| NPI | 1770600736 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERMAN O. SMOCK Principle Share Holder 434-237-2928 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: VA VA 0005531) |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2020-08-22 |