Organization
STATESVILLE AMY KINLAW PLLC
Active
Other names
Iredell Pediatric Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
KAROL MANCHOLA (REGIONAL MANAGER)
(828) 635-9200
Entity
Organization
Contact information
Practice address
1316 DAVIE AVE STE C, STATESVILLE, NC 28677-3561
(828) 635-9200
Mailing address
167 1ST AVE SW, TAYLORSVILLE, NC 28681-2639
(828) 635-9200
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
10/12/2021
Last updated
10/12/2021
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