| NPI | 1962936104 |
|---|---|
| Doing Business As | MALLARD CREEK FAMILY DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | MELISSA GUSTAFSON Practice Owner 704-596-0021 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: NC 7153) |
| Enumeration Date | 2017-04-14 |
| Last Update Date | 2017-04-14 |