| NPI | 1609949155 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAWLEY HARRISON FULLER Dentist & Owner 336-226-0855 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 6491) |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2014-12-19 |