| NPI | 1578071221 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINA C PATE Revenue Cycle Director 910-484-7070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry |
| Additional Taxonomies | 1223G0001X Dentist General Practice |
| Enumeration Date | 2018-01-16 |
| Last Update Date | 2025-08-20 |