| NPI | 1124189279 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER D MULLENIX Owner 251-471-3381 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2018-04-20 |