| NPI | 1285120816 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRE'SHAWNA WHITE Finance Director 336-955-1379 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2018-07-06 |
| Last Update Date | 2022-03-28 |