| NPI | 1356362065 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY LYNN ANDERSON Business Manger 910-295-8088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NC 6685) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2020-08-22 |