| NPI | 1659557072 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL A MICHELAKIS Partner 910-754-4507 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 3235) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NC 7012) |
| 1223G0001X Dentist, General Practice (Licence: NC 7663) | |
| Enumeration Date | 2008-01-16 |
| Last Update Date | 2008-06-24 |