| Idlewild Family Dentistry | |
|
4801 Indian Trail Fairview Rd Indian Trail NC 28079-8865 | |
| (704) 893-0351 | |
| (704) 893-0354 |
| Full Name | Idlewild Family Dentistry |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 4801 Indian Trail Fairview Rd, Indian Trail, North Carolina |
| Authorized Official Name and Position | Mitesh Dhulab (OWNER) |
| Authorized Official Contact | 7048930351 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Idlewild Family Dentistry 4801 Indian Trail Fairview Rd Indian Trail NC 28079-8865 Ph: (704) 893-0351 | Idlewild Family Dentistry 4801 Indian Trail Fairview Rd Indian Trail NC 28079-8865 Ph: (704) 893-0351 |
| NPI Number | 1649783119 |
|---|---|
| Provider Enumeration Date | 11/07/2017 |
| Last Update Date | 11/07/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649783119 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
| 261QS1200X | Clinic/center - Sleep Disorder Diagnostic | (* (Not Available)) | Secondary |
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