| NPI | 1790111953 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMIE LEIGH DOUGLAS Insurance Coordinator 910-483-9546 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: NC 8750) |
| Enumeration Date | 2013-09-19 |
| Last Update Date | 2013-09-19 |