| Purple Tooth Dental | |
|
112 Woodlawn Ave Mt Holly NC 28120-1775 | |
| (704) 885-2266 | |
| Not Available |
| Full Name | Purple Tooth Dental |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 112 Woodlawn Ave, Mt Holly, North Carolina |
| Authorized Official Name and Position | Andy Mancini (CEO) |
| Authorized Official Contact | 7048852266 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Purple Tooth Dental 112 Woodlawn Ave Mt Holly NC 28120-1775 Ph: (704) 885-2266 | Purple Tooth Dental 112 Woodlawn Ave Mt Holly NC 28120-1775 Ph: (704) 885-2266 |
| NPI Number | 1841955945 |
|---|---|
| Provider Enumeration Date | 11/03/2021 |
| Last Update Date | 11/06/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841955945 | NPI | - | NPPES |
| 1982835831 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |