| NPI | 1619125804 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAWNSURAE HAKIM Office Manager 704-405-5690 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NC 8339) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: NC 7528) |
| 1223G0001X Dentist General Practice (Licence: NC 8243) | |
| Enumeration Date | 2008-09-03 |
| Last Update Date | 2008-09-17 |