| NPI | 1730361460 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALDEN KEITH PHILLIPS President 336-765-3712 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: NC 5742) |
| Enumeration Date | 2007-12-05 |
| Last Update Date | 2007-12-05 |