| NPI | 1184353799 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA LEVINGSTON PEETERS Practice Manager 704-701-7104 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Enumeration Date | 2022-06-08 |
| Last Update Date | 2022-06-08 |