| NPI | 1083886345 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE HEANEY Owner 910-791-7380 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NC 6504) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NC 7278) |
| Enumeration Date | 2008-03-27 |
| Last Update Date | 2008-03-27 |