| NPI | 1295111219 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID GRAHAM Owner 757-547-7070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401414963) |
| Enumeration Date | 2015-07-31 |
| Last Update Date | 2015-07-31 |