| NPI | 1558684985 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONDELL LUCIAN BLAKEY Owner 919-435-0632 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NC 8515) |
| Enumeration Date | 2010-03-12 |
| Last Update Date | 2010-03-12 |