| NPI | 1225176589 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD IRA LEFTON President Dentist 757-467-6000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0A01005132) |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2020-08-22 |