| NPI | 1073297396 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA NOELLE GROESCHEL Director 704-978-9800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2023-06-15 |
| Last Update Date | 2023-06-15 |