| NPI | 1972775740 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YOLANDA D CLARK Business Assistant 704-869-9661 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NC 7237) |
| Enumeration Date | 2008-04-01 |
| Last Update Date | 2008-04-01 |