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Organization

KATIE KICKERTZ DDS MS PLLC

Active
Other names
Premier Endodontics of SouthPark
Organization subpart
No

Provider details

NPI number
Authorized official
KATIE R KICKERTZ DDS, MS (OWNER DENTIST)
(815) 222-2102
Entity
Organization

Contact information

Practice address
6842 CARNEGIE BLVD STE 200, CHARLOTTE, NC 28211-3500
(980) 423-1272
(980) 423-1273
Mailing address
6842 CARNEGIE BLVD STE 200, CHARLOTTE, NC 28211-3500
(980) 423-1272
(980) 423-1273

Taxonomy

Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary

Other

Enumeration date
05/11/2023
Last updated
05/11/2023
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