| Name | Value |
|---|---|
| PROVIDER TYPE | Dental Providers |
| CLASSIFICATION | Dentist |
| DEFINITION | A dentist who assesses, diagnoses, and treats patients with complex chronic orofacial pain and dysfunction disorders, oromotor and jaw behavior disorders, and chronic head/neck pain. The dentist has successfully completed an accredited postdoctoral orofac |
| AREA OF SPECIALIZATION | Orofacial Pain |
| STATUS | Active |
| VA CODE | V030511 |
| X12 CODE | 1223X2210X |
| SPECIALTY CODE | C5 |
| INDIVIDUAL/NON | INDIVIDUAL |
| MASTER ENTRY FOR VUID | YES |
| VUID | 5330360 |
| EFFECTIVE DATE/TIME |
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