Organization
PARK CEDAR DENTISTRY PARTNERSHIP
Active
Other names
Park Cedar Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUMMER L CALDWELL DDS (PARTNER)
(704) 752-0500
Entity
Organization
Contact information
Practice address
10027 PARK CEDAR DR, STE 100, CHARLOTTE, NC 28210-8903
(704) 752-0500
(704) 752-0502
Mailing address
10027 PARK CEDAR DR, STE 100, CHARLOTTE, NC 28210-8903
(704) 752-0500
(704) 752-0502
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
9488
NC
1223G0001X
General Practice Dentistry
Primary
7809
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
98190
BLUE CROSS BLUE SHIELD
NC
Enumeration date
05/24/2005
Last updated
02/10/2015
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