| NPI | 1740653021 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANE LANGLEY Owner/Orthodontist 251-625-2525 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: AL AL5418) |
| Enumeration Date | 2015-11-09 |
| Last Update Date | 2019-04-03 |