| NPI | 1578006276 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAWN M PERRY Office Manager 704-332-2532 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 5058) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NC 10033) |
| Enumeration Date | 2016-11-29 |
| Last Update Date | 2016-11-29 |