| NPI | 1467167262 |
|---|---|
| Doing Business As | EAST BLVD DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | KEVIN JALALI Owner 704-237-0507 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2023-01-17 |
| Last Update Date | 2023-01-17 |