| NPI | 1780899500 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HENRY CHRISTOPHER BLAKE President 910-762-8245 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC NC5127) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2020-08-22 |