| NPI | 1043466089 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH BERNARD BOYD Owner 757-558-9008 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401007988) |
| Enumeration Date | 2008-08-11 |
| Last Update Date | 2008-08-11 |