| NPI | 1871583393 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE A. BOWLES Business Manager 757-259-3254 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223D0001X Dentist Dental Public Health (Licence: VA 0401002784) |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2008-04-02 |