| NPI | 1700361003 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN OLIVER Owner 251-639-0801 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2018-10-02 |
| Last Update Date | 2018-10-02 |