Individual
BASSAM A ISSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
B.D.S.
Contact information
Practice address
1000 BLYTHE BLVD, CHARLOTTE, NC 28203-5812
(704) 355-4197
(704) 355-5301
Mailing address
1000 BLYTHE BLVD, CHARLOTTE, NC 28203-5812
(704) 355-4197
(704) 355-5301
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
AC5385578-R608
NC
Other
Enumeration date
05/05/2010
Last updated
04/12/2016
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