| NPI | 1811614209 |
|---|---|
| Doing Business As | PROVIDENCE PEDIATRIC DENTISTRY & ORTHODONTICS |
| Entity Type | Organization |
| Authorized Contact | ADAM GEOFFREY DANZE Orthodontist/Owner 704-975-1735 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2022-10-26 |
| Last Update Date | 2022-10-26 |