| NPI | 1922271840 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE LYNN SMITH Secretary 336-228-7749 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NC 3265) |
| Enumeration Date | 2008-04-11 |
| Last Update Date | 2008-04-11 |