| NPI | 1013147909 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK PCOLINSKI Owner 919-217-4411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NC 8020) |
| Additional Taxonomies | 122300000X Dentist (Licence: NC 7711) |
| Enumeration Date | 2009-07-26 |
| Last Update Date | 2009-10-21 |