NPI | 1801940788 |
---|---|
Entity Type | Organization |
Authorized Contact | TAMMY MORAN Comptroller 910-814-2944 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 4785) |
Enumeration Date | 2007-01-22 |
Last Update Date | 2020-08-22 |