| NPI | 1548787344 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA L HARRELL Office Administrator 910-799-9699 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 9067) |
| Enumeration Date | 2017-08-23 |
| Last Update Date | 2022-07-21 |