| NPI | 1871908517 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAURUS KELLEY TATEM President/Partner 540-891-5521 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0401410327) |
| Enumeration Date | 2014-06-20 |
| Last Update Date | 2014-06-20 |