| NPI | 1184490104 |
|---|---|
| Doing Business As | FAIRMONT FAMILY DENTAL |
| Entity Type | Organization |
| Authorized Contact | GEORGE TIMOTHY HALL CEO 910-521-2900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2023-11-30 |
| Last Update Date | 2023-11-30 |