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 |