Organization
GASTON FAMILY HEALTH SERVICES DENTAL
Active
Parent organization
GASTON FAMILY HEALTH SERVICES, INC.
Other names
GFHS Pediatric Dentistry
Organization subpart
Yes
Provider details
NPI number
Legal business name
GASTON FAMILY HEALTH SERVICES, INC.
Authorized official
ROBERT SPENCER MPH (EXECUTIVE DIRECTOR)
(704) 853-5261
Entity
Organization
Contact information
Practice address
991 W HUDSON BLVD, GASTONIA, NC 28052-6430
(704) 853-5079
Mailing address
991 W HUDSON BLVD, GASTONIA, NC 28052-6430
(704) 853-5079
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
344574
—
NC
05
—
890256H
—
NC
05
—
ZAN 978
—
SC
Enumeration date
03/30/2009
Last updated
11/27/2018
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