| NPI | 1982638193 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN R SUMMERS President 252-756-1456 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NC 5854) |
| Additional Taxonomies | 122300000X Dentist (Licence: NC 6573) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2020-08-22 |