| NPI | 1326077694 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL JEFFREY PHILLIPPI General Partner 704-509-4513 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 5170) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NC 6838) |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2020-08-22 |