Organization
MODLIN & LONDRY XVII DDS PLLC
Active
Other names
Triad Perio
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA HUNTER (DIRECTOR OF NETWORK RELATIONS)
(704) 780-4597
Entity
Organization
Contact information
Practice address
203 BOULEVARD ST, HIGH POINT, NC 27262-4301
(336) 889-5466
(336) 889-6898
Mailing address
19810 W CATAWBA AVE STE C, CORNELIUS, NC 28031-4057
(704) 780-4597
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
04/09/2026
Last updated
04/09/2026
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