| NPI | 1841343308 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH DALE OWEN Orthodontist 704-366-8006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NC 2908) |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2020-08-22 |