| NPI | 1316156102 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOYCE S DAVIS Office Manager 757-471-6672 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 401007977) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2008-04-07 |