| NPI | 1649317629 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA LANG Office Manager 757-488-8884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401005645) |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2008-07-14 |