| University Place | |
|
8401 University Exc Dr Suite 110 Charlotte NC 28262 | |
| (704) 547-1970 | |
| (704) 547-1926 |
| Full Name | University Place |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 8401 University Exc Dr, Charlotte, North Carolina |
| Authorized Official Name and Position | Raymond Garrison (PRESIDENT) |
| Authorized Official Contact | 7045491509 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| University Place 8401 University Exc Pkwy Suite 110 Charlotte NC 28262 Ph: (704) 547-1970 | University Place 8401 University Exc Dr Suite 110 Charlotte NC 28262 Ph: (704) 547-1970 |
| NPI Number | 1265563852 |
|---|---|
| Provider Enumeration Date | 03/08/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265563852 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 3549 (North Carolina) | Primary |
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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 | |
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