| NPI | 1992939714 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURIE ANN BIRSCH CEO 757-398-1234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: VA 0401410098) |
| Enumeration Date | 2009-05-07 |
| Last Update Date | 2009-05-07 |