| NPI | 1417125741 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA L. WELLENER President 910-295-1010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: NC 8518) |
| Enumeration Date | 2008-02-20 |
| Last Update Date | 2008-02-20 |