| NPI | 1770758559 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY GREENE Financial Administrator 919-471-1064 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 4766) |
| Enumeration Date | 2008-04-23 |
| Last Update Date | 2008-04-23 |