| NPI | 1912297623 |
|---|---|
| Doing Business As | MODERN FAMILY DENTAL CARE |
| Entity Type | Organization |
| Authorized Contact | TAJ MICHAEL HAYNES President 704-979-3436 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 8832) |
| Enumeration Date | 2011-04-14 |
| Last Update Date | 2011-04-14 |