| NPI | 1871811208 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HUGH TELLER President 434-296-4012 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401007562) |
| Enumeration Date | 2010-05-10 |
| Last Update Date | 2018-06-01 |