| NPI | 1881819480 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN TOLLE Business Manager 704-872-8934 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 6730) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2020-08-22 |