| NPI | 1073638110 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE K BARR President 757-422-0005 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: VA VA0401-005555) |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2020-08-22 |