| NPI | 1144782509 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REINALDO LASANTA-GARCIA Member 919-493-1402 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Additional Taxonomies | 1223P0700X Dentist Prosthodontics |
| Enumeration Date | 2019-04-04 |
| Last Update Date | 2019-04-14 |