Organization
LONDRY, MODLIN, TUCKER V DDS PLLC
Active
Other names
Lewisville Pediatric Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
LISA TRAVIS (DIRECTOR OF FINANCE)
(704) 997-8878
Entity
Organization
Contact information
Practice address
6570 SHALLOWFORD RD STE 110, LEWISVILLE, NC 27023-8651
(704) 997-8878
Mailing address
20311 CHARTWELL CENTER DR., PO BOX 2127, CORNELIUS, NC 28031
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
11/13/2024
Last updated
11/13/2024
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