| NPI | 1265823272 |
|---|---|
| Doing Business As | HAMPTON ROADS PEDIATRIC DENTISTRY AND ORTHODONTICS, PLLC |
| Entity Type | Organization |
| Authorized Contact | GRACE O DAVIS Business Administrator 757-369-1754 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: VA 0401410912) |
| Additional Taxonomies | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: VA 0401414620) |
| 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: VA 0401412905) | |
| Enumeration Date | 2015-02-12 |
| Last Update Date | 2019-04-12 |