| NPI | 1861031874 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY GELL Owner 704-784-4625 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2019-12-23 |
| Last Update Date | 2020-01-02 |