| NPI | 1265777197 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC BRANDON LOVELL Dentist 757-484-1675 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401411496) |
| Enumeration Date | 2012-12-04 |
| Last Update Date | 2012-12-04 |