| NPI | 1154533024 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN BRUCE KOEBLEY President 919-934-4664 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 4364) |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2020-08-22 |