| NPI | 1750485165 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WAYNE CLARK ANDERSON Dds 910-326-3611 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NC 2996) |
| Enumeration Date | 2006-09-08 |
| Last Update Date | 2020-08-22 |