| NPI | 1790556645 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES-THOMAS COOKE Member 704-749-5700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2024-01-10 |
| Last Update Date | 2024-01-10 |