| NPI | 1215171822 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAWN HAKIM Office Manager 704-494-7990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NC 7528) |
| Additional Taxonomies | 122300000X Dentist (Licence: NC 8243) |
| 122300000X Dentist (Licence: NC 8336) | |
| 122300000X Dentist (Licence: NC 8681) | |
| Enumeration Date | 2009-04-27 |
| Last Update Date | 2009-04-27 |