Organization
PINEVILLE DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LINABEN V MISTRY D.D.S. PA (OWNER)
(704) 543-4200
Entity
Organization
Contact information
Practice address
10410 PARK RD, SUITE-500, CHARLOTTE, NC 28210-8474
(704) 543-4200
(704) 543-4209
Mailing address
10410 PARK RD, SUITE-500, CHARLOTTE, NC 28210-8474
(704) 543-4200
(704) 543-4209
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7072
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5920836
—
NC
Enumeration date
10/15/2012
Last updated
10/15/2012
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