NPI | 1689019945 |
---|---|
Entity Type | Organization |
Authorized Contact | SHANEAN MICHELLE ANDERSON President/Owner 919-825-1795 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: NC 8755) |
Enumeration Date | 2013-04-30 |
Last Update Date | 2013-04-30 |