| NPI | 1972149789 |
|---|---|
| Doing Business As | GENERAL & IMPLANT DENTISTRY OF TIDEWATER |
| Entity Type | Organization |
| Authorized Contact | TY JUSTICE Director, Payer Relations 513-808-4984 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2019-11-27 |
| Last Update Date | 2024-03-07 |