| NPI | 1053340109 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUTH ANN MCDOWELL DAUGHTRY Administrative Assistant 336-768-1332 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2006-07-01 |
| Last Update Date | 2024-10-07 |