NPI | 1528557824 |
---|---|
Doing Business As | VIBRANT SMILE DENTISTRY |
Entity Type | Organization |
Authorized Contact | REBECCA DOUGLASS Office Manager 757-466-1700 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401412950) |
Enumeration Date | 2018-05-02 |
Last Update Date | 2018-05-02 |