| NPI | 1477203461 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA HUNTER Director Of Network Relations 704-780-4597 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2022-03-24 |
| Last Update Date | 2026-04-09 |