| NPI | 1346755956 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM HARPER President 757-659-1017 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2017-12-05 |
| Last Update Date | 2018-12-13 |