| NPI | 1497180749 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE R MALARY Office Manager 919-266-5332 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223D0001X Dentist, Dental Public Health (Licence: NC 8159) |
| Additional Taxonomies | 122300000X Dentist (Licence: NC 9329) |
| Enumeration Date | 2013-09-05 |
| Last Update Date | 2013-09-05 |