NPI | 1245992999 |
---|---|
Entity Type | Organization |
Authorized Contact | ALICIA DUFFY Credentialing Manager 919-295-2757 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist |
Additional Taxonomies | 1223G0001X Dentist, General Practice |
Enumeration Date | 2021-10-11 |
Last Update Date | 2022-04-28 |