| NPI | 1962861278 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALAN A GODEL Owner 704-218-2500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NC 7564) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NC 9056) |
| Enumeration Date | 2016-02-15 |
| Last Update Date | 2016-02-15 |