| NPI | 1760694921 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBIN E KIRCHEVAL Practice Administrator 757-420-4035 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: VA 5426) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2011-06-24 |