| NPI | 1083453278 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENEE DYKEN Owner/Orthdontist 251-223-3896 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2024-05-20 |
| Last Update Date | 2024-05-20 |