| NPI | 1821183583 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS LEE STOVER President 704-864-8393 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 1059) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2020-08-22 |