| NPI | 1659696888 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWN M CONRAD President 910-762-1555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NC 1711) |
| Enumeration Date | 2010-03-31 |
| Last Update Date | 2010-03-31 |