| NPI | 1801962196 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES WAITSEL ROBERTS Dentist 704-664-5437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NC 7023) |
| Additional Taxonomies | 122300000X Dentist (Licence: NC 7002) |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2020-08-22 |