| NPI | 1902172539 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELANIE RESENDES Owner 804-275-1622 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401412368) |
| Enumeration Date | 2012-03-28 |
| Last Update Date | 2012-03-28 |