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1205500147
TASHANA DETWILER
CONCORD, NC
NPI
1205500147
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1223D0001X Dentist, Dental Public Health
(Licence: NC 12420)
Enumeration Date
2021-08-04
Last Update Date
2021-08-04
Business Address
TASHANA DETWILER DMD
280 CONCORD PKWY S STE 110A
CONCORD, NC 28027-2704
Phone number: 704-920-1070
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Mailing Address
TASHANA DETWILER DMD
5008 SHADOW PINE DR
CHARLOTTE, NC 28269-5142
Phone number: 704-780-3714
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