NPI | 1710384938 |
---|---|
Doing Business As | OAK GROVE DENTAL |
Entity Type | Organization |
Authorized Contact | BEBE GUNTER JACKSON Manager 910-863-2377 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Additional Taxonomies | 122300000X Dentist |
1223G0001X Dentist, General Practice (Licence: NC 9387) | |
Enumeration Date | 2014-12-03 |
Last Update Date | 2022-07-21 |