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 |