| NPI | 1811065279 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT GLEN BOOKHOLT Preident 704-545-3109 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: NC 3531) |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2020-08-22 |