| NPI | 1225804677 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHRYN SUDIKOFF Owner 704-632-9922 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2023-11-28 |
| Last Update Date | 2023-11-28 |