| NPI | 1942472907 |
|---|---|
| Doing Business As | COLLEGE LAKES FAMILY DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | TRACIE WILLIAMS-LEGETTE Dentist 910-482-4442 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2008-03-31 |
| Last Update Date | 2008-03-31 |