| NPI | 1639340318 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOREY EDWARD PARKHURST Dentist 910-392-1905 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NC 6167) |
| Additional Taxonomies | 122300000X Dentist (Licence: NC 7586) |
| Enumeration Date | 2008-03-20 |
| Last Update Date | 2008-03-20 |