| NPI | 1871750745 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY J. KUCHTJAK President/Pediatric Dentist 704-883-8516 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NC 7068) |
| Enumeration Date | 2008-05-19 |
| Last Update Date | 2008-05-20 |