| NPI | 1760766737 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARNI VOORHEES HUSSON Vice President And Orthodontist 757-495-3110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: VA 0401102544) |
| Enumeration Date | 2011-10-07 |
| Last Update Date | 2011-10-07 |