| NPI | 1366717530 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA JOHNSTON Operations Manager 704-522-1550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NC 4305) |
| Enumeration Date | 2012-03-20 |
| Last Update Date | 2013-09-10 |