| NPI | 1225580392 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW THOMAS ERTL Doctor/President 828-687-7271 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: NC 8680) |
| Enumeration Date | 2016-10-25 |
| Last Update Date | 2017-03-24 |