Provider Demographics
NPI:1821298670
Name:CRANIAL FACIAL IMAGING CENTER LLC
Entity Type:Organization
Organization Name:CRANIAL FACIAL IMAGING CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:F
Authorized Official - Last Name:MORRISON
Authorized Official - Suffix:JR
Authorized Official - Credentials:DMD
Authorized Official - Phone:757-476-6714
Mailing Address - Street 1:7151 RICHMOND RD
Mailing Address - Street 2:SUITE 306
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23188-7234
Mailing Address - Country:US
Mailing Address - Phone:757-476-6714
Mailing Address - Fax:757-476-6715
Practice Address - Street 1:7151 RICHMOND RD
Practice Address - Street 2:SUITE 306
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188-7234
Practice Address - Country:US
Practice Address - Phone:757-476-6714
Practice Address - Fax:757-476-6715
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-20
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401007138122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty