| NPI | 1689427767 |
|---|---|
| Doing Business As | CAROLINA KIDS DENTISTRY - BLAKENEY |
| Entity Type | Organization |
| Authorized Contact | MARY CHAFFIN Credentialing Specialist 704-799-8878 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2024-04-09 |
| Last Update Date | 2024-08-13 |