| NPI | 1366857989 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MILAGROS DIAZ Owner/Dentist 704-218-2132 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 9035) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NC 8914) |
| Enumeration Date | 2014-06-23 |
| Last Update Date | 2014-06-23 |