| NPI | 1740342690 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACK I CHERIN Owner 757-497-8611 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223D0001X Dentist, Dental Public Health (Licence: VA 0401003088) |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2020-08-22 |