| NPI | 1053859090 |
|---|---|
| Doing Business As | SOUTH BOULEVARD DENTAL |
| Entity Type | Organization |
| Authorized Contact | SARAH BELLE ROGERS Office Manager 980-819-1817 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC NC7145) |
| Enumeration Date | 2017-02-10 |
| Last Update Date | 2017-02-10 |