| NPI | 1396811584 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL HOWARD Office Manager 757-340-2400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: VA 0401004245) |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2020-08-22 |