| NPI | 1992952600 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON S WOODSIDE Provider 540-341-4111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401410401) |
| Enumeration Date | 2008-08-25 |
| Last Update Date | 2008-08-25 |