| NPI | 1962429712 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL CLAYBORN WALTERS President 910-671-4601 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 8190) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2020-08-22 |