| NPI | 1801251343 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH T. ESPARZA Owner 757-499-4707 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: VA 0401411188) |
| Enumeration Date | 2015-12-29 |
| Last Update Date | 2015-12-29 |