| NPI | 1093987612 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY RENEE SEVERT President 919-929-2365 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NC 6384) |
| Enumeration Date | 2008-03-25 |
| Last Update Date | 2008-03-25 |