NPI | 1124090535 |
---|---|
Entity Type | Organization |
Authorized Contact | RANDOLPH ELLIOTT SAVAGE President 757-499-0567 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 4706) |
Enumeration Date | 2006-02-02 |
Last Update Date | 2020-08-22 |