| NPI | 1508917592 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY MORAN Com PT Roller 910-814-2944 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NC 4785) |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2008-10-02 |