# PINEVILLE DENTISTRY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548512593
- **Authorized official:** DR. LINABEN V MISTRY D.D.S. PA (OWNER)
- **Authorized official phone:** (704) 543-4200

## Contact information

- **Practice address:** 10410 PARK RD, SUITE-500, CHARLOTTE, NC 28210-8474
- **Practice address phone:** (704) 543-4200
- **Practice address fax:** (704) 543-4209
- **Mailing address:** 10410 PARK RD, SUITE-500, CHARLOTTE, NC 28210-8474
- **Mailing address phone:** (704) 543-4200
- **Mailing address fax:** (704) 543-4209

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 7072 | NC | Yes |

## Other

- **Enumeration date:** 10/15/2012
- **Last updated:** 10/15/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 5920836 | — | NC |