| NPI | 1750568416 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL ODELL GIVENS President 704-536-2299 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: NC 5082) |
| Enumeration Date | 2008-01-24 |
| Last Update Date | 2008-01-24 |