| NPI | 1811136476 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RODERIC BROWN CEO 336-955-1379 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| 1223D0001X Dentist, Dental Public Health | |
| 122300000X Dentist | |
| Enumeration Date | 2009-02-05 |
| Last Update Date | 2025-10-22 |