| NPI | 1639559016 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUKE K. DALZELL Endodontist/Owner 706-604-9144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: NC 9892) |
| Enumeration Date | 2015-06-01 |
| Last Update Date | 2015-06-01 |