| NPI | 1841310810 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANK T GROGAN Dentist 434-797-3598 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: VA 0401005363) |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2020-08-22 |