| NPI | 1881730117 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN A HOCKADAY Owner 704-553-2348 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 7289) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NC 3061) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2020-08-22 |