| NPI | 1609916782 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA M BRUNELL Front Office Coordinator 704-896-0515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 6149) |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2020-08-22 |