| NPI | 1063923332 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE L OVERMAN Office Manager 336-882-4181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 3016) |
| Enumeration Date | 2017-10-13 |
| Last Update Date | 2017-10-13 |