| NPI | 1568565711 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARL LEE BASS President/Dentist 704-873-3321 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 6420) |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2020-08-22 |