Organization
LONDRY, MODLIN, TUCKER II DDS PLLC
Active
Other names
Silas Creek Adult and Pediatric Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
JALONDA SWEENEY (CREDENTIALING SPECIALIST)
(704) 997-8878
Entity
Organization
Contact information
Practice address
705 COLISEUM DR NW, WINSTON-SALEM, NC 27106-5312
(336) 721-7921
(336) 721-2011
Mailing address
19810 W CATAWBA AVE STE A1, CORNELIUS, NC 28031-4056
(704) 997-8878
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
—
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
11/14/2023
Last updated
11/14/2023
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