Individual
MICHAEL SMITH HUMPHRIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
9920 COULOAK DR STE 100, CHARLOTTE, NC 28216-8923
(704) 392-7676
Mailing address
2543 PINCKNEY AVE, CHARLOTTE, NC 28205-1857
(704) 206-0077
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12293
NC
Other
Enumeration date
06/28/2021
Last updated
06/28/2021
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