| NPI | 1881463172 |
|---|---|
| Doing Business As | MY DENTAVILLE |
| Entity Type | Organization |
| Authorized Contact | MANSI SHAH Dentist 336-249-2906 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2023-12-27 |
| Last Update Date | 2023-12-27 |