| NPI | 1376647859 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY RANDALL BEK Director 757-426-6151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401007256) |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2012-12-12 |