| NPI | 1316620156 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM HARPER President / Owner 757-659-1017 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2023-08-09 |
| Last Update Date | 2025-12-05 |