| NPI | 1285120816 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RODERIC BROWN CEO 336-955-1379 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) | |
| Enumeration Date | 2018-07-06 |
| Last Update Date | 2025-09-08 |