| NPI | 1548553589 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY CUMMINGS DAVIDIAN Pediatric Dentist 336-624-8967 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2011-05-24 |
| Last Update Date | 2012-03-27 |