| NPI | 1093922106 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY DAWN O'HARA Office Manager 910-350-3508 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: NC 6733) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2020-08-22 |