| NPI | 1003502519 |
|---|---|
| Doing Business As | SOUTH PARK ORAL SURGERY |
| Entity Type | Organization |
| Authorized Contact | KEVIN P BOND Dentist/Owner 704-366-8707 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2023-04-17 |
| Last Update Date | 2023-04-17 |