NPI | 1255802674 |
---|---|
Doing Business As | GENESIS FAMILY DENTISTRY |
Entity Type | Organization |
Authorized Contact | STACEY ALSTON Dentist/Owner 704-594-5442 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2018-12-11 |
Last Update Date | 2018-12-11 |