Individual
JAY J COYLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
491 N. WENDOVER RD, CHARLOTTE, NC 28211-1064
(704) 540-5400
(704) 540-5400
Mailing address
6923 SHANNON WILLOW RD, SUITE 100, CHARLOTTE, NC 28226-1331
(704) 540-5400
(704) 540-6326
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5279
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8991824
—
NC
Enumeration date
04/19/2007
Last updated
07/09/2007
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