| NPI | 1801124789 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARRY C FARRELL President 910-508-2346 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 4592) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NC 8316) |
| Enumeration Date | 2009-12-03 |
| Last Update Date | 2009-12-03 |