| Southpark Periodontics | |
|
6719 Fairview Rd Charlotte NC 28210-3879 | |
| (704) 366-2774 | |
| (704) 366-2639 |
| Full Name | Southpark Periodontics |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 6719 Fairview Rd, Charlotte, North Carolina |
| Authorized Official Name and Position | Bobby L Cockerham (OWNER) |
| Authorized Official Contact | 7043662774 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southpark Periodontics 6719 Fairview Rd Charlotte NC 28210-3879 Ph: (704) 366-2774 | Southpark Periodontics 6719 Fairview Rd Charlotte NC 28210-3879 Ph: (704) 366-2774 |
| NPI Number | 1225582596 |
|---|---|
| Provider Enumeration Date | 08/04/2016 |
| Last Update Date | 07/21/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225582596 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | 4673 (North Carolina) | Secondary |
| 1223P0300X | Dentist - Periodontics | 9124 (North Carolina) | Primary |
Stephen C. Wheeler, Dds, Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 130 Providence Rd, Charlotte, NC 28207 Phone: 704-377-1444 | |
George J Stuart Jr Dds Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2040 A Randolph Rd, Charlotte, NC 28207 Phone: 704-377-1885 Fax: 704-374-1731 | |
Southend Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1520 South Blvd, Suite 110, Charlotte, NC 28203 Phone: 704-335-8266 Fax: 704-335-8267 | |
Monique D Mceachern Dds Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 10226 Couloak Drive, Ste 100, Charlotte, NC 28216 Phone: 704-971-7272 Fax: 704-971-7522 | |
Drs Reimels & Miller Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3410 Central Ave, Charlotte, NC 28205 Phone: 704-900-7301 | |
South Park Oral Surgery Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2719 Coltsgate Rd, Charlotte, NC 28211 Phone: 704-366-8707 Fax: 704-366-8717 | |
Raynald L. Desameau Dmd Pllc Iv Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 10460 Park Rd, Charlotte, NC 28210 Phone: 704-540-5440 |