| NPI | 1861653974 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA LYNN HOCKETT Office Administrator 804-379-9375 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 401006912) |
| Enumeration Date | 2008-06-20 |
| Last Update Date | 2008-06-20 |