| NPI | 1487981031 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TODD L STEWART Owner 704-235-6075 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NC 8124) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: NC 7528) |
| 1223G0001X Dentist General Practice (Licence: NC 8336) | |
| 1223G0001X Dentist General Practice (Licence: NC 8681) | |
| Enumeration Date | 2009-11-03 |
| Last Update Date | 2009-11-03 |