| NPI | 1639253065 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA S. WILEY President 919-735-5999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: NC 200001384207) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2020-08-22 |