| NPI | 1962714873 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBIN MARIE GREENE Practice Administrator 757-962-6769 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: VA 0401412189) |
| Enumeration Date | 2010-07-08 |
| Last Update Date | 2010-07-08 |