| NPI | 1891852307 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDITH M DODD Office Mgr 757-483-2110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: VA S011456-3) |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2013-11-12 |