| NPI | 1922101393 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAMERON M HEYDARI Dentist 540-949-0137 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251K00000X Public Health or Welfare (Licence: VA 0401410833) |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2020-08-22 |