| NPI | 1780853259 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM BAILEY PRUDEN Owner/Dentist 757-549-8077 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401008656) |
| Enumeration Date | 2008-02-28 |
| Last Update Date | 2008-02-28 |