| NPI | 1164558664 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAULA JEAN WOODSWORTH Secretary Treasurer 919-751-5995 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NC 5318) |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2020-08-22 |