| NPI | 1770794612 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN EVERETT CROSLAND Proprietor 704-484-0148 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist Periodontics (Licence: NC NC4891) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2018-06-21 |