| NPI | 1801003538 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANICE H ELLIOTT Office Manager Dental Hygienist 704-364-8685 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NC 3619) |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2020-08-22 |