| NPI | 1205076668 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMELIA BURNETTE Human Relations/Fin Coordinator 336-451-1957 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NC 6832) |
| Enumeration Date | 2009-02-25 |
| Last Update Date | 2009-02-25 |