| NPI | 1154475036 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICIA MARIE DUFFY Credentialing Manager 919-295-2757 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 4785) |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2023-03-08 |