DANA POINT

SOUTHPORT, NC
NPI1659665560
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy208800000X Urology
(Licence: NC  2016-00414)
Enumeration Date2011-06-08
Last Update Date2021-11-03
Business Address
DANA POINT MD
4222 LONG BEACH RD SE
SOUTHPORT, NC 28461-8627
Phone number: 910-763-2510
Mailing Address
DANA POINT MD
PO BOX 936857
ATLANTA, GA 31193-6857
Phone number: 910-662-8765
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