| NPI | 1366636771 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GILBERT J FREY Dentist 757-253-0400 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0401004237) |
| Additional Taxonomies | 122300000X Dentist (Licence: VA 040100388) |
| Enumeration Date | 2007-08-29 |
| Last Update Date | 2007-08-29 |