| NPI | 1922417112 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JORGE PELAEZ Owner/Dentist 757-961-4300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: VA 0401411435) |
| Enumeration Date | 2014-08-13 |
| Last Update Date | 2014-08-13 |