| NPI | 1972900512 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH STONER President 804-266-2400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: VA 0401005143) |
| Enumeration Date | 2014-11-25 |
| Last Update Date | 2014-11-25 |