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Organization

GASTON FAMILY HEALTH SERVICES, INC.

Active
Parent organization
GASTON FAMILY HEALTH SERVICES, INC
Other names
Gaston Family Health Services DENTAL
Organization subpart
Yes

Provider details

NPI number
Legal business name
GASTON FAMILY HEALTH SERVICES, INC
Authorized official
MS. KAREN F. EDWARDS (DENTAL BUSINESS ADMINISTRATOR)
(704) 862-6182
Entity
Organization

Contact information

Practice address
991 W HUDSON BLVD, GASTONIA, NC 28052-6430
(704) 862-6182
(704) 671-1404
Mailing address
991 W HUDSON BLVD, GASTONIA, NC 28052-6430
(704) 862-6182
(704) 671-1404

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
261QF0400X
Federally Qualified Health Center (FQHC)
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
344574D
NC
Enumeration date
03/13/2013
Last updated
03/13/2013
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