| NPI | 1346464583 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN JAMES ROUSE Manager 704-366-2001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: NC 8216) |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2020-08-22 |