| NPI | 1538189469 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN MARIE MCKINLEY Dentist 704-867-7116 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NC NC6114) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2020-08-22 |