| NPI | 1114228475 |
|---|---|
| Doing Business As | PREMIER PEDIATRICS OF EDEN |
| Entity Type | Organization |
| Authorized Contact | KENNETH K BOGGS CFO/Treasurer 336-832-8005 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics |
| Enumeration Date | 2010-11-03 |
| Last Update Date | 2012-11-29 |