| NPI | 1922024702 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY INGLE CAPARELLI President 910-392-2920 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NC 7011) |
| Additional Taxonomies | 122300000X Dentist (Licence: NC 6831) |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2020-08-22 |