Individual
JIMMY KAYASTHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1000 BLYTHE BLVD, CHARLOTTE, NC 28203-5812
(704) 355-4197
(704) 355-5301
Mailing address
1000 BLYTHE BLVD, CHARLOTTE, NC 28203-5812
(704) 355-4197
(704) 355-5301
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
150639
NC
Other
Enumeration date
08/08/2007
Last updated
08/08/2007
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