| NPI | 1679249056 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA ELLIOTT REEVES Owner 919-500-3909 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2021-08-17 |
| Last Update Date | 2021-08-20 |