| NPI | 1215157706 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT EDWARD ANDERSON President 757-934-3000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: VA 4978) |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2020-08-22 |