| NPI | 1477944395 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA DAY COLLIE Vice President Admin. And Fiscal Se 336-506-4410 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2015-02-13 |
| Last Update Date | 2015-02-13 |