| NPI | 1801101803 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT M JENSEN Owner 336-379-1500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NC 5555) |
| Enumeration Date | 2010-08-13 |
| Last Update Date | 2011-06-27 |