| NPI | 1508392358 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHNETTE BRANTLEY HARGIS Administrative Assistant 919-467-7360 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NC 6422) |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2017-05-11 |