| NPI | 1053545236 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | NICOLE LECANN Owner 919-789-8682  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 7000)  | 
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NC 6970)  | 
| Enumeration Date | 2009-05-04 | 
| Last Update Date | 2009-05-04 |