| NPI | 1376868398 |
|---|---|
| Doing Business As | MAIN STREET FAMILY DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | JENINE GILES Dentist/Partner 704-301-6157 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NC 8604) |
| Additional Taxonomies | 122300000X Dentist (Licence: NC 8595) |
| Enumeration Date | 2010-04-01 |
| Last Update Date | 2010-04-01 |