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 |