| NPI | 1013230887 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILLIP DANIEL BEAVER President 704-872-8934 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 8056) |
| Enumeration Date | 2010-03-09 |
| Last Update Date | 2010-03-09 |