| NPI | 1568592434 |
|---|---|
| Doing Business As | WAVERLY PLACE |
| Entity Type | Organization |
| Authorized Contact | RAYMOND GARRISON President 704-549-1509 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NC 3549) |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2020-08-22 |