Individual
MAKSIM KAZANTCEV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
ONE MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2160
Mailing address
ONE MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/13/2023
Last updated
04/18/2023
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