| NPI | 1346493582 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THEODORE F. MAYER Owner 800-409-2563 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 5450) |
| Enumeration Date | 2008-10-31 |
| Last Update Date | 2013-03-11 |