| NPI | 1952689150 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAREK O ZAKI Owner 757-416-1100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: VA 0401006804) |
| Enumeration Date | 2011-07-22 |
| Last Update Date | 2011-07-22 |