| NPI | 1578799383 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CURTIS SERGIO VENDETTI Owner 757-430-7690 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: VA 0401411275) |
| Additional Taxonomies | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: VA 0101236322) |
| Enumeration Date | 2009-06-08 |
| Last Update Date | 2009-06-08 |