| NPI | 1851896104 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE RENAE MALARY Office Manager 919-266-5332 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: NC 8159) |
| Enumeration Date | 2018-03-28 |
| Last Update Date | 2018-03-28 |