| NPI | 1982963799 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN EDWARD TRUITT Owner & President 804-789-0230 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery |
| Enumeration Date | 2012-05-14 |
| Last Update Date | 2012-05-14 |