NPI | 1386300630 |
---|---|
Doing Business As | LWSS FAMILY DENTISTRY - VIRGINIA BEACH - KEMPSVILLE RD. |
Entity Type | Organization |
Authorized Contact | HILLARY THULL Credentialing Coordinator 217-540-8946 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2021-11-11 |
Last Update Date | 2021-11-11 |