| NPI | 1245494319 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELE GAY Receptionist 757-337-0451 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: VA 0401412222) |
| Enumeration Date | 2008-07-17 |
| Last Update Date | 2008-07-17 |