| NPI | 1861688202 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL PAIGE FOLCK President 757-340-9146 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2007-09-19 |
| Last Update Date | 2007-09-19 |