| NPI | 1447374129 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAUNCY FITCH NELSON Orthodontist 910-860-1991 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NC 5591) |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2022-09-19 |