| NPI | 1932371606 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THEODORE BRANDON THOMAS President 910-592-6171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: NC 4818) |
| Enumeration Date | 2008-04-02 |
| Last Update Date | 2008-04-02 |