| NPI | 1992988232 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | MARTY JONES SMITH Office Manager 804-364-8366 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: VA 0401410390) | 
| Enumeration Date | 2007-12-10 | 
| Last Update Date | 2007-12-10 |