| NPI | 1821297193 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEONARD HELMS HALTIWANGER Owner/President 910-997-2204 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: NC 6566) |
| Enumeration Date | 2007-07-16 |
| Last Update Date | 2007-07-16 |