| NPI | 1083065437 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER BISHOPP Practice Manager 704-242-2800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: NC 9984) |
| Enumeration Date | 2016-06-27 |
| Last Update Date | 2026-02-19 |