| NPI | 1093963761 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN L KORDULAK Dentist 757-495-4700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: VA VA4781) |
| Enumeration Date | 2008-09-05 |
| Last Update Date | 2008-09-05 |