| NPI | 1275752180 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD RAYMOND PENCE Owner 704-489-8221 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: NC 3590) |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2011-11-08 |