| NPI | 1154525996 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY T DILLON Office Manager 919-471-4630 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NC 5783) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2020-08-22 |