| NPI | 1720573587 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIRGINIA T JONES CEO 910-485-7070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry |
| Additional Taxonomies | 1223D0004X Dentist Dentist Anesthesiologist |
| 1223E0200X Dentist Endodontics | |
| 1223P0106X Dentist Oral and Maxillofacial Pathology | |
| 1223P0300X Dentist Periodontics | |
| 1223S0112X Dentist Oral and Maxillofacial Surgery | |
| 1223X0008X Dentist Oral and Maxillofacial Radiology | |
| 163WP0200X Registered Nurse Pediatrics | |
| 204E00000X Oral & Maxillofacial Surgery | |
| 2086S0127X Surgery Trauma Surgery | |
| 261QA1903X Clinic/Center Ambulatory Surgical | |
| 363AM0700X Physician Assistant Medical | |
| Enumeration Date | 2018-06-25 |
| Last Update Date | 2018-06-25 |