| NPI | 1780955773 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH KULNIS Office Administarior 757-686-3444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2012-01-23 |
| Last Update Date | 2012-01-23 |