| NPI | 1053550145 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MANISHA D PATEL Owner 704-799-0552 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NC 6332) |
| Additional Taxonomies | 122300000X Dentist (Licence: NC 6771) |
| Enumeration Date | 2009-02-12 |
| Last Update Date | 2009-02-12 |