| NPI | 1497090864 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARA S CRUSER Office Manager 757-490-3111 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401005830) |
| Enumeration Date | 2012-12-11 |
| Last Update Date | 2012-12-11 |