| NPI | 1134391196 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT A MENAKER Owner 704-377-2503 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NC 5451) |
| Additional Taxonomies | 122300000X Dentist (Licence: NC 8283) |
| Enumeration Date | 2008-03-31 |
| Last Update Date | 2015-02-04 |