NPI | 1902071350 |
---|---|
Doing Business As | CLINTON FAMILY DENTISTRY |
Entity Type | Organization |
Authorized Contact | DERWOOD CLARK Manager 910-596-0606 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2008-04-28 |
Last Update Date | 2008-04-28 |