# CT MAXILLOFACIAL IMAGING, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134154651
- **Authorized official:** DR. BRIAN H WILLSON D.D.S. (MANAGER)
- **Authorized official phone:** (910) 484-3000

## Contact information

- **Practice address:** 3415A MELROSE RD, FAYETTEVILLE, NC 28304-1608
- **Practice address phone:** (910) 484-3000
- **Mailing address:** 3415A MELROSE RD, FAYETTEVILLE, NC 28304-1608
- **Mailing address phone:** (910) 484-3000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2471C3401X | Computed Tomography Radiologic Technologist | — | NULL | Yes |
| 2471C3401X | Computed Tomography Radiologic Technologist | — | — | Yes |

## Other

- **Enumeration date:** 07/12/2006
- **Last updated:** 08/22/2020