| NPI | 1972996197 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL E SCROGGINS LLC Member 540-989-5257 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: VA 0401413811) |
| Enumeration Date | 2015-03-12 |
| Last Update Date | 2015-03-12 |