| NPI | 1851968762 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFF COHEN COO 704-246-8971 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2021-06-09 |
| Last Update Date | 2024-10-09 |