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 |