| NPI | 1144996711 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERRON S BRADY Owner/Dentist 704-321-0414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2021-08-23 |
| Last Update Date | 2021-09-09 |