| NPI | 1316404130 |
|---|---|
| Doing Business As | DENTISTRY OF THE CAROLINAS - SOUTHPARK |
| Entity Type | Organization |
| Authorized Contact | SIMONE WALSH VP Accounts 704-522-1550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2019-02-28 |
| Last Update Date | 2019-02-28 |