| NPI | 1891969135 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL L DAOULAS Financial Coordinator 804-414-0713 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2008-04-17 |
| Last Update Date | 2008-04-17 |