| NPI | 1558426874 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN PATRICK OMALLEY President 704-374-1221 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NC 3852) |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2008-03-04 |