NPI | 1457936163 |
---|---|
Entity Type | Organization |
Authorized Contact | TIFFANY LORICK Credentialing Specialist 919-948-6787 |
Organization Subpart ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
Enumeration Date | 2021-03-15 |
Last Update Date | 2021-04-10 |