| NPI | 1255042073 |
|---|---|
| Doing Business As | LIGHTHOUSE DENTAL GROUP |
| Entity Type | Organization |
| Authorized Contact | SHANNON CRONAN Office Administrator 757-430-9448 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2022-12-13 |
| Last Update Date | 2022-12-13 |