| NPI | 1114447703 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK D NEWMAN President 757-965-5194 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0443000025) |
| Additional Taxonomies | 261QR1300X Clinic/Center, Rural Health |
| Enumeration Date | 2017-06-23 |
| Last Update Date | 2026-03-13 |