NPI | 1972641561 |
---|---|
Entity Type | Organization |
Authorized Contact | J. MATTHEW HOGENDOBLER Owner 757-481-7811 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401007115) |
Enumeration Date | 2007-02-03 |
Last Update Date | 2020-08-22 |