| NPI | 1831256650 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN E KONIKOFF President 757-583-1535 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401004880) |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2023-09-26 |