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Organization
LONDRY & MODLIN DDS PLLC
Active
Organization
LONDRY & MODLIN DDS PLLC
Active
Other names
Lakeside Dental
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLE DIMASCIO (OFFICE MANAGER)
(704) 987-9087
Entity
Organization
Contact information
Practice address
19824 W CATAWBA AVE, SUITE B, CORNELIUS, NC 28031-4046
(704) 987-9087
(704) 987-9044
Mailing address
19824 W CATAWBA AVE, SUITE B, CORNELIUS, NC 28031-4046
(704) 987-9087
(704) 987-9044
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
NULL
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
09/07/2012
Last updated
09/07/2012
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