| NPI | 1902535396 |
|---|---|
| Doing Business As | STATESVILLE DENTAL |
| Entity Type | Organization |
| Authorized Contact | MARY CHAFFIN Credentialing Specialist 704-997-8878 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2022-06-09 |
| Last Update Date | 2024-03-21 |