| NPI | 1952850877 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA ELIZABETH GODWIN Owner 919-522-7720 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: NC 1254) |
| Enumeration Date | 2016-10-04 |
| Last Update Date | 2016-10-27 |