| NPI | 1992867840 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OSAMA S MODJODIDI Dentist 757-497-8611 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223D0001X Dentist, Dental Public Health (Licence: VA 0401410783) |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2008-07-18 |