| NPI | 1780074385 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLETTE GELIN Billing Manager 9104-333-7199 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: NC 7896) |
| Enumeration Date | 2015-02-03 |
| Last Update Date | 2015-02-03 |