| NPI | 1740636281 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIN SNIPES POPE Credentialing Manager 919-639-0264 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
| Enumeration Date | 2016-05-13 |
| Last Update Date | 2016-05-13 |