| NPI | 1679573075 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IVAN SCHIFF President 757-962-6769 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 004356/l02257) |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2020-08-22 |