| NPI | 1124196993 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN LEE RENNER Dentist 919-876-3196 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 3217) |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2008-06-23 |