| NPI | 1508873613 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNY J MORRIS Dentist President 910-762-0786 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NC 5935) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: NC 5951) |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2020-08-22 |