| NPI | 1477759710 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA BELK Director Of Business Services 704-296-4816 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental |
| Additional Taxonomies | 261QC1500X Clinic/Center Community Health |
| Enumeration Date | 2007-06-25 |
| Last Update Date | 2008-06-27 |