| NPI | 1952315301 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDON L CLARKE Office Manager 336-621-1554 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NC 5525) |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2013-07-30 |