| NPI | 1922193002 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LANCE CHRISTOPHER HANKINSON Dentist 251-433-7717 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AL 5226) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: AL S-779-TA-178) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2014-08-01 |