| NPI | 1770824435 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN E ST. GEORGE Owner 804-861-5237 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401412498) |
| Enumeration Date | 2013-03-06 |
| Last Update Date | 2013-05-07 |