| NPI | 1245546308 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD ALAN REAMER President 910-762-0355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NC 8201) |
| Additional Taxonomies | 122300000X Dentist (Licence: NC 3714) |
| 1223G0001X Dentist, General Practice (Licence: NC 3714) | |
| Enumeration Date | 2010-08-27 |
| Last Update Date | 2010-08-27 |