| NPI | 1447502380 |
|---|---|
| Doing Business As | SEASIDE DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | JASON CAMPBELL Managing Member/Owner 757-301-8465 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2012-10-02 |
| Last Update Date | 2012-10-02 |