| NPI | 1124572417 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN PATRICK SZAKALY Director 757-484-2382 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: VA 401411215) |
| Enumeration Date | 2016-08-04 |
| Last Update Date | 2016-08-04 |