| NPI | 1316163850 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GAIL CHILDERS Office Administrator 910-483-9546 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NC 4973) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2008-10-21 |