Individual
MS. DIANA CAROLINA MANRIQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
11535 CARMEL COMMONS BLVD, SUITE 200, CHARLOTTE, NC 28226-5313
(704) 540-2443
Mailing address
5905 SYCAMORE HILL LN, APT. 1214, CHARLOTTE, NC 28277-4566
(704) 759-8805
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
7400
NC
Other
Enumeration date
02/05/2007
Last updated
07/08/2007
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