| NPI | 1326323254 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY N KENNEY Owner 757-595-1457 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: VA 0401006963) |
| Enumeration Date | 2011-10-11 |
| Last Update Date | 2011-10-11 |