| NPI | 1720573587 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIRGINIA T JONES CEO 910-485-7070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Additional Taxonomies | 1223D0004X Dentist, Dentist Anesthesiologist Speciality |
| 1223E0200X Dentist, Endodontics | |
| 1223P0106X Dentist, Oral and Maxillofacial Pathology | |
| 1223P0221X Dentist, Pediatric Dentistry | |
| 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 | |
| 363AM0700X Physician Assistant, Medical | |
| Enumeration Date | 2018-06-25 |
| Last Update Date | 2024-08-21 |