Individual
DR. KAYCEE OBI-GWACHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2200 WALTERS DIVISION RD, MONROE, NC 28110
(704) 289-1105
Mailing address
19810 W CATAWBA AVE # A1, CORNELIUS, NC 28031-4056
(910) 644-2884
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
11139
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/18/2017
Last updated
08/29/2018
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