Individual
RAYNALD LEON DESAMEAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
10460 PARK RD, CHARLOTTE, NC 28210-8536
(704) 540-5440
Mailing address
10460 PARK RD, CHARLOTTE, NC 28210-8536
(704) 540-5440
(704) 540-5441
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
11583
NC
Other
Enumeration date
08/22/2019
Last updated
10/28/2024
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