| NPI | 1821507401 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETSY HENDRICKS Office Manager 252-331-2050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2017-09-26 |
| Last Update Date | 2021-03-16 |