Organization
GREAT SMILES DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MITESH B DHULAB DMD (OWNER)
(704) 893-0351
Entity
Organization
Contact information
Practice address
15060 IDLEWILD RD, ST F, MATTHEWS, NC 28104-3602
(704) 893-0351
(704) 893-0354
Mailing address
15060 IDLEWILD RD, ST F, MATTHEWS, NC 28104-3602
(704) 893-0351
(704) 893-0354
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7424
NC
Other
Enumeration date
04/27/2016
Last updated
08/10/2016
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