China Grove Dental | |
307 E Thom St China Grove NC 28023-2363 | |
(704) 855-5200 | |
Not Available |
Full Name | China Grove Dental |
---|---|
Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 307 E Thom St, China Grove, North Carolina |
Authorized Official Name and Position | Don Holloman (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 7047922203 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
China Grove Dental 202 Mcgill Ave Nw Ste D Concord NC 28025-4615 Ph: (704) 792-2292 | China Grove Dental 307 E Thom St China Grove NC 28023-2363 Ph: (704) 855-5200 |
NPI Number | 1265043574 |
---|---|
Provider Enumeration Date | 08/11/2020 |
Last Update Date | 02/07/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1265043574 | NPI | - | NPPES |
334071A | Medicaid | NC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | (* (Not Available)) | Secondary |
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |