| NPI | 1013193465 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY GRICE BULLARD Receptionist 910-642-7741 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: NC 3921) |
| Enumeration Date | 2008-01-16 |
| Last Update Date | 2008-01-16 |