| NPI | 1598996928 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE M BUCKMAN Office Manager 336-510-2600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 7488) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NC 7327) |
| Enumeration Date | 2009-08-03 |
| Last Update Date | 2009-08-03 |