| NPI | 1275681702 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH G KORDSMEIER Owner 336-272-6235 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC NC 7724) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2020-08-22 |