| NPI | 1952479156 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JON DOUGLAS LESAN Owner Dentist 910-347-1211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2023-03-07 |