| NPI | 1043243124 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN FRANK NEELY President 910-295-8088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NC 7678) |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2020-08-22 |