Individual
CHARLES STACY MAXWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4950 CAMERON RD, HOPE MILLS, NC 28348-2456
(910) 424-1918
(910) 424-5893
Mailing address
4950 CAMERON RD, HOPE MILLS, NC 28348-2456
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
04663
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8995579
—
NC
Enumeration date
07/11/2006
Last updated
07/08/2007
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