| NPI | 1437286101 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT M. EDMONDS President 757-484-4832 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: VA 8012) |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2020-08-22 |