| NPI | 1902952021 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM CARVAJAL President 434-832-8040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: VA 0101233899) |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2020-08-22 |