| NPI | 1053072611 |
|---|---|
| Doing Business As | WAXHAW DENTAL CENTER |
| Entity Type | Organization |
| Authorized Contact | CHAD HENDRICKS Credentialing 612-859-0444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2022-01-06 |
| Last Update Date | 2022-01-06 |