| NPI | 1275819708 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILLIP BUTTS VP Contracts And Development 919-863-9763 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NC 4785) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NC 4785) |
| 1223P0300X Dentist, Periodontics (Licence: NC 4785) | |
| Enumeration Date | 2011-10-28 |
| Last Update Date | 2011-10-28 |