| NPI | 1093970626 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LIZ RUSSELL Practice Administrator 919-462-9338 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 7007) |
| Enumeration Date | 2008-07-23 |
| Last Update Date | 2008-07-23 |