| NPI | 1316324411 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALVA JULIUS MORRIS Asst Clinical Accountant 252-737-7035 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2015-04-28 |
| Last Update Date | 2015-05-01 |