| NPI | 1154581932 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PRASHANT RAVI RAO Owner 704-443-7379 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 8322) |
| Enumeration Date | 2008-06-15 |
| Last Update Date | 2008-06-15 |