| NPI | 1023697836 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFF COHEN COO 704-246-8971 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
| Enumeration Date | 2021-04-07 |
| Last Update Date | 2021-04-07 |