| NPI | 1316454655 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA LYNN BISHOP President/Owner 919-489-2793 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NC 07110) |
| Enumeration Date | 2018-01-09 |
| Last Update Date | 2018-01-09 |