| NPI | 1114216843 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDALL L BITTNER Doctor Manager 757-425-1335 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: VA 0401008030) |
| Enumeration Date | 2011-04-04 |
| Last Update Date | 2011-04-04 |