Organization
GASTON FAMILY HEALTH SERVICES, INC.
Active
Other names
GFS General Dental Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT SPENCER (EXECUTIVE DIRECTOR)
(704) 853-5261
Entity
Organization
Contact information
Practice address
991 W HUDSON BLVD, GASTONIA, NC 28052-6430
(704) 853-5079
Mailing address
991 W HUDSON BLVD, GASTONIA, NC 28052-6430
(704) 853-5079
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
344574A
—
NC
01
—
890256H
NC MEDICAID HOSPITAL SERVICES
NC
05
—
ZAN978
—
SC
Enumeration date
03/23/2009
Last updated
03/23/2009
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