Organization
LONDRY, MODLIN, TUCKER IV DDS PLLC
Active
Other names
Carolina Kids Dentistry - Blakeney
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA HUNTER (DIRECTOR OF NETWORK RELATIONS)
(704) 780-4597
Entity
Organization
Contact information
Practice address
9817 SUZANNE CT STE B, WAXHAW, NC 28173-6976
(704) 997-8878
Mailing address
20311 CHARTWELL CENTER DR., PO BOX #2127, CORNELIUS, NC 28031
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
—
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
04/09/2024
Last updated
04/09/2026
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