| NPI | 1275632366 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAFAYETTE JUDKINS Dentist 336-342-0474 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NC 4781) |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2020-08-22 |