| NPI | 1619328515 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN SINCLAIR President 757-222-3731 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: VA 0401412790) |
| Enumeration Date | 2016-06-22 |
| Last Update Date | 2016-06-22 |