| NPI | 1104845270 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRINA METHENEY Office Manager 704-847-4717 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NC 4847) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2020-08-22 |