Organization
CEDAR WALK FAMILY AND COSMETIC DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PRASHANT RAVI RAO D.D.S. (OWNER)
(704) 443-7379
Entity
Organization
Contact information
Practice address
16615 RIVERSTONE WAY, SUITE 200, CHARLOTTE, NC 28277-5746
(704) 542-9923
Mailing address
2434 GRIMMERSBOROUGH LN, CHARLOTTE, NC 28270-3714
(704) 443-7379
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8322
NC
Other
Enumeration date
06/15/2008
Last updated
06/15/2008
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