Name | Value |
---|---|
PROVIDER TYPE | Dental Providers |
CLASSIFICATION | Denturist |
STATUS | Active |
VA CODE | V030600 |
X12 CODE | 122400000X |
reserved | A, Try V03---- |
SPECIALTY CODE | 19 |
INDIVIDUAL/NON | INDIVIDUAL |
MASTER ENTRY FOR VUID | YES |
VUID | 5252504 |
EFFECTIVE DATE/TIME |
|