| NPI | 1841647682 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TORI IRVINE Doctor 704-846-1401 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NC 9275) |
| Additional Taxonomies | 122300000X Dentist (Licence: NC 7073) |
| Enumeration Date | 2016-05-23 |
| Last Update Date | 2016-06-06 |