| NPI | 1467649681 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YVONNE ALLEN Office Mgr. 336-378-1150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 4164) |
| Enumeration Date | 2007-10-02 |
| Last Update Date | 2007-10-02 |