| NPI | 1053634733 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA ANN BULLOCK Office Manager 910-342-9210 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 3714) |
| Enumeration Date | 2010-03-09 |
| Last Update Date | 2010-03-11 |