Organization
GASTON FAMILY HEALTH SERVICES INC
Active
Other names
Dental Services
Organization subpart
No
Provider details
NPI number
Authorized official
PENELOPE STUBBS (EXECUTIVE ASSISTANT)
(704) 853-5294
Entity
Organization
Contact information
Practice address
991 W HUDSON BLVD, GASTONIA, NC 28052-6430
(704) 853-5079
(704) 862-5383
Mailing address
991 W HUDSON BLVD, GASTONIA, NC 28052-6430
(704) 853-5079
(704) 862-5383
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
890256H
—
NC
Enumeration date
03/02/2011
Last updated
03/02/2011
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