| NPI | 1023036837 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY B OVERTON Administrator 252-537-1054 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 4908) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2018-03-01 |