| NPI | 1235237348 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD PATRICK JOHNSON President 704-536-9214 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 3684) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2007-08-02 |