| NPI | 1295907285 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEETH M. LANE Vice President 251-947-5940 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AL 4306) |
| Enumeration Date | 2008-03-31 |
| Last Update Date | 2008-03-31 |