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Organization

CHARLES DELAINE D.M.D., PLLC

Active
Other names
Delaine Dental
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CHARLES DELAINE (DENTIST/OWNER)
(828) 693-0911
Entity
Organization

Contact information

Practice address
520 S ALLEN RD, SUITE 4, FLAT ROCK, NC 28731-9450
(828) 693-0911
(828) 693-9529
Mailing address
520 S ALLEN RD, SUITE 4, FLAT ROCK, NC 28731-9450
(828) 693-0911
(828) 693-9529

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
8328
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5910127
NC
Enumeration date
04/30/2012
Last updated
05/02/2012
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