| NPI | 1649307836 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN PAUL MIDGETTE President Owner 757-483-4700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0401411578) |
| Additional Taxonomies | 122300000X Dentist (Licence: VA 0401006913) |
| 122300000X Dentist (Licence: VA 0401004372) | |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2008-07-14 |