| NPI | 1871528331 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY EDWARD TAYLOR President 757-477-0536 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2024-02-29 |