Organization
S. SHEMBO ETIENNE, D.D.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHANGO SHEMBO ETIENNE D.D.S. (OWNER)
(704) 996-8608
Entity
Organization
Contact information
Practice address
10400 MALLARD CREEK RD, SUITE 103, CHARLOTTE, NC 28262-9772
(704) 996-8608
Mailing address
10400 MALLARD CREEK RD, SUITE 103, CHARLOTTE, NC 28262-9772
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
04/23/2015
Last updated
04/23/2015
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