| NPI | 1821148511 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY BAILEY Owner, President 757-486-7857 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: VA 0401007646) |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2020-08-22 |