| NPI | 1588756803 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JON CHARLES PACKMAN Dentist 704-873-2211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 7159) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2013-07-03 |