| NPI | 1831303429 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATALINA BALCERO Office Manager 704-523-7301 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: NC 7223) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2020-08-22 |