| NPI | 1013131036 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WHITNEY K BALES President 919-934-3409 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 6000) |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2020-08-22 |