| NPI | 1649480633 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFERY T WINGATE Secretary 919-329-0140 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 7039) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2008-06-13 |