| NPI | 1932327277 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETSY ANN HAGAN Senior Associate Dean 804-828-7978 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: VA 0401005311) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2020-08-22 |