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General NPI Number Information
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NPI Number | 1912152711
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Entity Type | Organization
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Legal Business Name | HARBOUR VIEW ORAL & FACIAL SURGERY PLLC
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Dates
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Enumeration Date | 11/20/2008
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Last Update Date | 11/19/2009
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Provider Practice Location Address
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Address Line | 5837 HARBOUR VIEW BLVD
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City | SUFFOLK
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State | VA
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Zip | 23435-2657
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Country | US
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Telephone | 757-686-2703
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Fax | 757-686-3737
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Provider Business Mailing Address
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Address Line | 5837 HARBOUR VIEW BLVD
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City | SUFFOLK
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State | VA
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Zip | 23435-2657
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Country | US
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Telephone | 757-686-2703
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Fax | 757-686-3737
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Authorized Official
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Title or Position | OWNER
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Name | ANNE E MORGAN
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Credential | DDS,MD
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Telephone | 757-686-2703
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 0401410077
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License Number State | VA
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