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Organization
CEDAR WALK FAMILY AND COSMETIC DENTISTRY
Active
Organization
CEDAR WALK FAMILY AND COSMETIC DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PRASHANT RAVI RAO D.D.S. (OWNER)
(704) 443-7379
Entity
Organization
Contact information
Practice address
16615 RIVERSTONE WAY, SUITE 200, CHARLOTTE, NC 28277-5746
(704) 542-9923
Mailing address
2434 GRIMMERSBOROUGH LN, CHARLOTTE, NC 28270-3714
(704) 443-7379
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8322
NC
Other
Enumeration date
06/15/2008
Last updated
06/15/2008
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