| Name | Value |
|---|---|
| PROVIDER TYPE | Dental Providers |
| CLASSIFICATION | Dentist |
| DEFINITION | The specialty of dentistry and discipline of radiology concerned with the production and interpretation of images and data produced by all modalities of radiant energy that are used for the diagnosis and management of diseases, disorders and conditions of the oral and maxillofacial region. |
| AREA OF SPECIALIZATION | Oral and Maxillofacial Radiology |
| STATUS | Active |
| VA CODE | V030510 |
| X12 CODE | 1223X0008X |
| SPECIALTY CODE | C5 |
| INDIVIDUAL/NON | INDIVIDUAL |
| MASTER ENTRY FOR VUID | YES |
| VUID | 5252498 |
| EFFECTIVE DATE/TIME |
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