| NPI | 1639502727 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICIA DUFFY Credentialing Manager 919-295-2757 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 4785) |
| Enumeration Date | 2013-08-13 |
| Last Update Date | 2024-03-18 |