| NPI | 1891915112 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MORGAN TREY WEIS Owner 757-484-8262 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: VA 0401410496) |
| Enumeration Date | 2007-04-27 |
| Last Update Date | 2012-05-02 |