| NPI | 1962837153 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN LEE HATCHER President 336-282-4022 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NC 7439) |
| Additional Taxonomies | 1223P0221X Dentist Pediatric Dentistry (Licence: NC 7444) |
| Enumeration Date | 2013-09-06 |
| Last Update Date | 2016-05-16 |