| NPI | 1255775979 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | UYEN N HOANG Dentist 251-648-8936 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AL Lno-5776) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: AL LNO-5776) |
| Enumeration Date | 2013-04-24 |
| Last Update Date | 2013-04-24 |