| NPI | 1710170634 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY CAROL ANDRESKI Secretary/Treasurer 336-667-1029 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 5790) |
| Enumeration Date | 2007-08-23 |
| Last Update Date | 2007-08-23 |