| NPI | 1861550634 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD JOSEPH WEISBERG President 757-440-0044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 4515) |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2007-09-07 |