| NPI | 1780745950 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES HENRY FRYAR Manager 704-663-1800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 3919) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2020-08-22 |