NPI | 1215499520 |
---|---|
Doing Business As | CHARLOTTE COMMUNITY HEALTH CLINIC FAMILY DENTISTRY |
Entity Type | Organization |
Authorized Contact | LISA M HOLMES COO 704-316-6561 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
Enumeration Date | 2019-04-04 |
Last Update Date | 2025-09-18 |