| NPI | 1700043148 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL JOHN DEANGELO Periodontist 919-467-3213 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: NC 7596) |
| Enumeration Date | 2008-05-22 |
| Last Update Date | 2008-05-22 |