| NPI | 1245810605 |
|---|---|
| Doing Business As | SOUTH WINSTON DENTAL |
| Entity Type | Organization |
| Authorized Contact | TIFFANY LORICK Credentialing Specialist 919-948-6787 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2021-04-10 |
| Last Update Date | 2021-04-10 |