| NPI | 1225310550 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARON Y COLVIN Owner 757-548-5619 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401008133) |
| Enumeration Date | 2011-09-13 |
| Last Update Date | 2011-09-13 |