| NPI | 1619208030 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL JACKSON BURROW Orthodontist 704-547-0803 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NC 4617) |
| Enumeration Date | 2010-01-25 |
| Last Update Date | 2010-01-26 |