Organization
GONSALVES AND WOLFF, DDS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RYAN E GONSALVES DDS (OWNER)
(919) 619-4166
Entity
Organization
Contact information
Practice address
104 WATERS EDGE CT, MOORESVILLE, NC 28117-5513
(919) 619-4166
Mailing address
104 WATERS EDGE CT, MOORESVILLE, NC 28117-5513
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8414
NC
Other
Enumeration date
05/05/2009
Last updated
05/05/2009
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