| NPI | 1851825533 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY BASHAM PIERCEY Office Administrator 336-663-8586 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery |
| Enumeration Date | 2017-04-19 |
| Last Update Date | 2017-04-19 |