| NPI | 1972055770 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVIS GARDNER Dentist/Owner 804-332-6310 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401412847) |
| Enumeration Date | 2016-10-27 |
| Last Update Date | 2016-10-27 |