# STEPHEN A. RENDULICH, DDS, PA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** The Center For Oral & Maxillofacial Surgery
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013173483
- **Authorized official:** LORA SIGMON (OFFICE ADMINISTRATOR)
- **Authorized official phone:** (704) 875-8833

## Contact information

- **Practice address:** 10210 HICKORYWOOD HILL AVE, SUITE 200, HUNTERSVILLE, NC 28078-3332
- **Practice address phone:** (704) 875-8833
- **Practice address fax:** (704) 875-0303
- **Mailing address:** 10210 HICKORYWOOD HILL AVE, SUITE 200, HUNTERSVILLE, NC 28078-3332
- **Mailing address phone:** (704) 875-8833
- **Mailing address fax:** (704) 875-0303

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 7749 | NC | Yes |

## Other

- **Enumeration date:** 08/05/2008
- **Last updated:** 08/05/2008