| NPI | 1558533315 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL O BELISLE CFO 910-762-2618 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NC 96000154) |
| Enumeration Date | 2008-04-01 |
| Last Update Date | 2008-04-01 |