| NPI | 1689833899 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARRELL A MEEKS Owner 757-499-5909 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: VA 0438000149) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: VA 041007337) |
| Enumeration Date | 2008-06-03 |
| Last Update Date | 2008-06-03 |