Organization
GANGLANI DMD PLLC
Active
Parent organization
GANGLANI DMD PLLC
Other names
Fresh Dental Park Road
Organization subpart
Yes
Provider details
NPI number
Legal business name
GANGLANI DMD PLLC
Authorized official
RICHARD B VELAZQUE (DIRECTOR OF IMPLEMENTATION)
(704) 218-2132
Entity
Organization
Contact information
Practice address
8420 PARK RD, CHARLOTTE, NC 28210-5801
(704) 910-3098
Mailing address
8420 PARK RD, CHARLOTTE, NC 28210-5801
(704) 910-3098
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
08/10/2020
Last updated
08/10/2020
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