| NPI | 1487699930 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | W DAVID SHORT Pres/Owner 252-728-4570 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 4403) |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2013-03-25 |