Organization
VIRGINIA ORTHODONTIC SPECIALIST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEXANDER WAITKUS DDS, MS (DOCTOR)
(757) 826-8511
Entity
Organization
Contact information
Practice address
2101 EXECUTIVE DR STE 5E, HAMPTON, VA 23666-2415
(757) 826-8511
Mailing address
2101 EXECUTIVE DR STE 5E, HAMPTON, VA 23666-2415
(757) 826-8511
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
0401004032
VA
Other
Enumeration date
06/04/2007
Last updated
08/22/2020
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