| NPI | 1962610873 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES SILAS LLEWELLYN President 757-428-2571 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA VA6246) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2016-02-16 |