Individual
QUEENATE IBETO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1000 BLYTHE BLVD, CHARLOTTE, NC 28203-5812
(704) 355-2165
Mailing address
300 HAMILTON ST NE, APT 213, WASHINGTON, DC 20011-6305
(704) 905-1338
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
21686738
NC
Other
Enumeration date
05/04/2016
Last updated
05/04/2016
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