| NPI | 1639253123 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA A MORGAN Pediatric Dentist 757-627-7550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0401008103) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: VA 0401005373) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2020-08-22 |