| NPI | 1285710400 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN M COCKRELL Partner 251-639-0110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AL 4059) |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2020-08-22 |