| NPI | 1427147875 | 
|---|---|
| Other Name | GLENWOOD VILLAGE DENTISTRY | 
| Entity Type | Organization | 
| Authorized Contact | BRIAN J KELLEHER President 919-782-4444  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: NC 1756)  | 
| Enumeration Date | 2006-10-12 | 
| Last Update Date | 2020-08-22 |