| NPI | 1841357928 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK JAY HERMELIN Dds Pc 757-497-4746 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401005631) |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2020-08-22 |