| NPI | 1770679110 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOWARD STANLEY DORFMAN Vice President 757-340-7000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: VA 2006113958R) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2020-08-22 |