| NPI | 1033521836 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BERTRAND A. BONNICK Owner 336-841-0000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 07672) |
| Enumeration Date | 2014-05-28 |
| Last Update Date | 2014-05-28 |