| NPI | 1851708390 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA HASELTON Director Of Aegd 804-828-3368 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: VA 0401414484) |
| Enumeration Date | 2014-07-16 |
| Last Update Date | 2014-07-16 |