| NPI | 1790764595 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD MICHAEL OKEEFE President 540-772-9515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0401008987) |
| Additional Taxonomies | 122300000X Dentist (Licence: VA 0401004137) |
| Enumeration Date | 2006-01-11 |
| Last Update Date | 2020-08-22 |