| NPI | 1881371813 |
|---|---|
| Doing Business As | PONDEROSA FAMILY DENTAL |
| Entity Type | Organization |
| Authorized Contact | LINDSEY SHALL Dentist 757-502-3659 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2023-06-30 |
| Last Update Date | 2023-07-06 |