| NPI | 1700336955 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN RICKER Pediatric Dentist 919-391-3813 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: NC 9311) |
| Enumeration Date | 2016-10-12 |
| Last Update Date | 2023-08-09 |