NPI | 1780080655 |
---|---|
Entity Type | Organization |
Authorized Contact | ROBERT LEE STUTTS Owner/Surgeon 336-272-4583 |
Organization Subpart ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NC 9065) |
Enumeration Date | 2014-11-05 |
Last Update Date | 2014-11-05 |