| NPI | 1366823759 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER CLARK Owner 919-610-7098 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 10080) |
| Enumeration Date | 2015-06-11 |
| Last Update Date | 2015-06-11 |