| NPI | 1992761126 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADAM CRAIG PLASTER President 276-322-4006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: VA 0401410196) |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2020-08-22 |