| NPI | 1518217975 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH A. CROUCH President 704-873-9641 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 5075) |
| Enumeration Date | 2012-09-13 |
| Last Update Date | 2012-09-13 |