| NPI | 1972767200 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL BURKE HOLBERT President 804-270-7824 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: VA 0401412060) |
| Enumeration Date | 2008-07-16 |
| Last Update Date | 2008-07-16 |