| NPI | 1275701336 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL JEREMY WILSON Owner 919-383-7423 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NC 7088) |
| Enumeration Date | 2008-02-12 |
| Last Update Date | 2008-02-12 |