| NPI | 1013164185 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLYNDA MCCONVILLE Owner/President 919-718-9188 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: NC 7021) |
| Enumeration Date | 2008-08-20 |
| Last Update Date | 2008-08-20 |