NPI | 1942950068 |
---|---|
Entity Type | Organization |
Authorized Contact | BRAD CHRISTENSON Doctor/Owner 757-482-7660 |
Organization Subpart ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
Enumeration Date | 2022-03-24 |
Last Update Date | 2022-03-24 |