| NPI | 1396111647 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACK T WINCHESTER Dentist Owner 252-247-3510 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 5372) |
| Enumeration Date | 2015-08-20 |
| Last Update Date | 2015-08-20 |