| NPI | 1396876223 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL MARTIN BRICKMAN President 757-499-9839 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 4604) |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2020-08-22 |