Indian Trail Dental Associates | |
136 Indian Trail Rd S Indian Trail NC 28079-9669 | |
(704) 821-7222 | |
(704) 821-4310 |
Full Name | Indian Trail Dental Associates |
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Speciality | Dentist - General Practice |
Location | 136 Indian Trail Rd S, Indian Trail, North Carolina |
Authorized Official Name and Position | Richard Mark Holmes (OWNER) |
Authorized Official Contact | 7048217222 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Indian Trail Dental Associates Po Box 338 Indian Trail NC 28079-0338 Ph: (704) 821-7222 | Indian Trail Dental Associates 136 Indian Trail Rd S Indian Trail NC 28079-9669 Ph: (704) 821-7222 |
NPI Number | 1689716599 |
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Provider Enumeration Date | 02/14/2007 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1689716599 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223G0001X | Dentist - General Practice | NC6039 (North Carolina) | Primary |
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