| NPI | 1740705219 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIN SNIPES POPE Credential Manager 919-277-7957 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Additional Taxonomies | 1223P0106X Dentist, Oral and Maxillofacial Pathology |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
| Enumeration Date | 2017-08-07 |
| Last Update Date | 2022-07-21 |