| NPI | 1669514576 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES DISDIER Dentist 919-583-0102 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 6975) |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2020-08-22 |