| NPI | 1326770462 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SLADJANA BJELAC Owner/Dentist 704-701-7104 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223G0001X Dentist General Practice |
| Enumeration Date | 2022-06-28 |
| Last Update Date | 2022-06-28 |