| NPI | 1477768489 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLENN W FRITZ President And Treasurer 757-484-9441 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: VA 4845) |
| Enumeration Date | 2007-05-12 |
| Last Update Date | 2020-08-22 |