| NPI | 1306933635 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN MARK OLIVER President 336-724-5054 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 7312) |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2023-03-07 |