Organization
HAYNES, LISSADE & ASSOCIATES, PLLC
Active
Other names
Long Creek Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PATRICE LISSADE DMD (CO-OWNER)
(610) 202-3230
Entity
Organization
Contact information
Practice address
8150 MOUNT HOLLY HUNTERSVILLE RD, SUITE A, CHARLOTTE, NC 28216-9791
(610) 202-3230
Mailing address
8150 MOUNT HOLLY HUNTERSVILLE RD, SUITE A, CHARLOTTE, NC 28216-9791
(610) 202-3230
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
02/25/2013
Last updated
04/22/2013
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