| NPI | 1316119373 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLA Y JOHNSON Rece PT Ionist 757-393-4361 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 3244) |
| Enumeration Date | 2008-03-31 |
| Last Update Date | 2008-03-31 |