| NPI | 1750569117 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERNEST JEROME GOODSON Orthodontist 910-483-2633 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management (Licence: NC 104771) |
| Enumeration Date | 2008-02-07 |
| Last Update Date | 2018-06-21 |