| NPI | 1205095163 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER DALE BRADLEY President 252-247-2169 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 6798) |
| Enumeration Date | 2008-06-05 |
| Last Update Date | 2009-03-09 |