| NPI | 1821360306 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD G COVERT Dentist 910-937-6454 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NC 6662) |
| Additional Taxonomies | 122300000X Dentist (Licence: NC 9795) |
| Enumeration Date | 2012-01-31 |
| Last Update Date | 2015-10-12 |