NPI | 1104017060 |
---|---|
Entity Type | Organization |
Authorized Contact | TERRY HENRY HAKE Owner Endodontist 757-229-4115 |
Organization Subpart ? | No |
Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: VA 0401008049) |
Enumeration Date | 2007-08-06 |
Last Update Date | 2007-08-06 |