Organization
SUPREME DENTAL HOSPITAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LOLADE SAMUEL-CASH DDS (SECRETARY)
(704) 465-2210
Entity
Organization
Contact information
Practice address
307 N. GREENE ST, WADESBORO, NC 28170-2182
(704) 465-2210
Mailing address
307 N. GREENE ST, WADESBORO, NC 28170-2182
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
1223G0001X
NC
Other
Enumeration date
07/16/2015
Last updated
07/16/2015
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