| NPI | 1841925898 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEEANNA LONDON Practice Manager 704-865-8521 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2022-07-22 |
| Last Update Date | 2022-07-22 |