| NPI | 1083993935 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI ANN WASHINGTON Billing Office Supervisor 757-595-8964 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: VA 6075) |
| Enumeration Date | 2011-08-10 |
| Last Update Date | 2011-08-10 |