| NPI | 1972777035 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WALTER SMITH LINVILLE President 252-237-5124 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NC 2481) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: NC 8202) |
| Enumeration Date | 2008-04-18 |
| Last Update Date | 2008-04-18 |