| NPI | 1457540346 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID WAYNE JOHNSON President 910-938-4333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: NC 6572) |
| Enumeration Date | 2007-10-17 |
| Last Update Date | 2007-10-17 |