| NPI | 1982096798 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOHAMED HASSAN AHMED Business Owner 804-270-9989 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 302R00000X Health Maintenance Organization (Licence: VA 0401411318) |
| Enumeration Date | 2015-03-03 |
| Last Update Date | 2024-03-25 |