| NPI | 1083938203 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK ANDREW TRIPP Owner 704-845-5538 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 7034) |
| Enumeration Date | 2010-03-17 |
| Last Update Date | 2012-01-23 |