| NPI | 1063694925 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILFRED J. MCCALL President 757-245-5822 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: VA 0401003988) |
| Enumeration Date | 2007-12-03 |
| Last Update Date | 2007-12-03 |