| 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 |