| NPI | 1437216959 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | JORDANA EFLAND Administrator 757-482-4777 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: VA 0401006218) | 
| Enumeration Date | 2007-01-03 | 
| Last Update Date | 2020-08-22 |