| NPI | 1821209669 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT ALLEN SIMMONS Owner 757-421-7181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 05289) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2020-08-22 |