| NPI | 1275500167 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | A TODD SMITH Oral Surgeon 336-765-9550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: NC 3596) |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: NC 5848) |
| 204E00000X Oral & Maxillofacial Surgery (Licence: NC 4949) | |
| Enumeration Date | 2006-03-01 |
| Last Update Date | 2010-03-19 |