Organization
KENDALYN LUTZ-CRAVER DDS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENDALYN PAIGE LUTZ-CRAVER DDS (PRESIDENT)
(704) 482-5119
Entity
Organization
Contact information
Practice address
101 LIFE ENRICHMENT BLVD., SHELBY, NC 28150
(704) 482-5119
(704) 669-2710
Mailing address
101 LIFE ENRICHMENT BLVD., SHELBY, NC 28150
(704) 482-5119
(704) 669-2710
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7628
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89902Y2
—
NC
01
—
902Y2
BCBS
NC
Enumeration date
09/06/2006
Last updated
10/26/2009
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