| NPI | 1487827135 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAMON DORSEY ROSS Provider/Member 919-423-0060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: TX 22685) |
| Enumeration Date | 2008-04-02 |
| Last Update Date | 2008-07-10 |