| NPI | 1447378336 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ED ISMAEL MARTINEZ President 336-378-9433 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: NC 6414) |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2020-08-22 |