| NPI | 1851746853 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIN S POPE Credentialing Manager 919-639-0264 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
| Enumeration Date | 2016-04-27 |
| Last Update Date | 2016-04-27 |