Organization
BHAVANA JAYARAM LLC
Active
Other names
Kannapolis Pediatric Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
BHAVANA JAYARAM DMD (DENTIST/OWNDER)
(704) 932-5000
Entity
Organization
Contact information
Practice address
1706 S MAIN ST, KANNAPOLIS, NC 28081-5924
(704) 932-5000
(704) 932-5006
Mailing address
1706 S MAIN ST, KANNAPOLIS, NC 28081-5924
(704) 932-5000
(704) 932-5006
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1194873489
—
NC
Enumeration date
03/05/2019
Last updated
02/01/2024
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