| NPI | 1497361422 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RALPH KOJO MENSAH Member 919-824-1530 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental |
| Additional Taxonomies | 261QS1200X Clinic/Center Sleep Disorder Diagnostic |
| Enumeration Date | 2020-09-16 |
| Last Update Date | 2021-02-23 |