# KENDALYN LUTZ-CRAVER DDS PA

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

## Provider details

- **NPI number:** 1881797066
- **Authorized official:** DR. KENDALYN PAIGE LUTZ-CRAVER DDS (PRESIDENT)
- **Authorized official phone:** (704) 482-5119

## Contact information

- **Practice address:** 101 LIFE ENRICHMENT BLVD., SHELBY, NC 28150
- **Practice address phone:** (704) 482-5119
- **Practice address fax:** (704) 669-2710
- **Mailing address:** 101 LIFE ENRICHMENT BLVD., SHELBY, NC 28150
- **Mailing address phone:** (704) 482-5119
- **Mailing address fax:** (704) 669-2710

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 7628 | NC | Yes |

## Other

- **Enumeration date:** 09/06/2006
- **Last updated:** 10/26/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 89902Y2 | — | NC |
| 01 | — | 902Y2 | BCBS | NC |