| NPI | 1649783119 |
|---|---|
| Doing Business As | IDLEWILD FAMILY DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | MITESH DHULAB Owner 704-893-0351 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 261QS1200X Clinic/Center, Sleep Disorder Diagnostic |
| Enumeration Date | 2017-11-07 |
| Last Update Date | 2017-11-07 |