| NPI | 1871768390 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROCHELLE DENISE CUBITT Office Manager 757-496-8070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: VA 0401002488) |
| Enumeration Date | 2008-04-25 |
| Last Update Date | 2011-11-03 |