| NPI | 1497160212 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEANA CLARE COOK Periodontist 910-256-8486 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist Periodontics (Licence: NC 8760) |
| Enumeration Date | 2014-07-01 |
| Last Update Date | 2015-10-06 |