Individual
DR. ETHAN KYLE CAUDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
343 WHITEVILLE RD NW, SHALLOTTE, NC 28470-4507
(910) 754-6718
Mailing address
343 WHITEVILLE RD NW, SHALLOTTE, NC 28470-4507
(910) 754-6718
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
11031
NC
Other
Enumeration date
06/05/2018
Last updated
06/05/2018
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