| NPI | 1548491723 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINA FONFARA COVINGTON Co Owner 828-322-4258 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 8829) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NC 8830) |
| Enumeration Date | 2009-08-05 |
| Last Update Date | 2009-08-05 |