| NPI | 1437160991 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL DOUGLAS NIFONG President 336-766-6457 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 4520) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2020-08-22 |