| NPI | 1447670120 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERYL BROWN Director Of Operations 757-784-8070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401007257) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401414304) |
| Enumeration Date | 2014-04-22 |
| Last Update Date | 2014-04-22 |