| NPI | 1629025564 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | S C TOLBERT President 910-484-6116 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NC 3726) |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2012-05-02 |