| NPI | 1114340700 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSE C BRADFORD President 704-364-8685 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 8780) |
| Enumeration Date | 2014-02-02 |
| Last Update Date | 2014-02-02 |