| NPI | 1134344609 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HARISH BHANUPRASAD PATEL Dentist/Owner 704-844-0556 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NC 8344) |
| Additional Taxonomies | 1223G0001X Dentist General Practice |
| 1223G0001X Dentist General Practice (Licence: NC 6833) | |
| 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics | |
| 122300000X Dentist | |
| 1223P0700X Dentist Prosthodontics | |
| 1223E0200X Dentist Endodontics | |
| 1223P0300X Dentist Periodontics | |
| 1223P0221X Dentist Pediatric Dentistry | |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2014-10-27 |