| NPI | 1295890515 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN DAVID NORTHCUTT President 251-928-8770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AL 4593) |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2020-08-22 |