| NPI | 1548907942 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH SHUTTERS VP For Financial Affairs, CFO, Memb 336-841-9202 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 125Q00000X Oral Medicine |
| Enumeration Date | 2022-05-17 |
| Last Update Date | 2022-05-17 |