| NPI | 1669159299 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHI TRONG PHAM Founder 757-277-2569 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2023-07-05 |
| Last Update Date | 2023-07-15 |