NPI | 1679203913 |
---|---|
Entity Type | Organization |
Authorized Contact | JENNIFER RAYLE HOCK Director Of Billing 704-295-4653 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery |
Enumeration Date | 2022-06-10 |
Last Update Date | 2022-12-01 |