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6570 Shallowford Rd Ste 110 Lewisville NC 27023-8651 | |
| (704) 997-8878 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 6570 Shallowford Rd Ste 110, Lewisville, North Carolina |
| Authorized Official Name and Position | Lisa Travis (DIRECTOR OF FINANCE) |
| Authorized Official Contact | 7049978878 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
20311 Chartwell Center Dr. Po Box 2127 Cornelius NC 28031 Ph: () - | 6570 Shallowford Rd Ste 110 Lewisville NC 27023-8651 Ph: (704) 997-8878 |
| NPI Number | 1831913037 |
|---|---|
| Provider Enumeration Date | 11/13/2024 |
| Last Update Date | 11/13/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831913037 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
Londry & Modlin Xv Dds Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 6570 Shallowford Rd Ste 100, Lewisville, NC 27023 Phone: 704-997-8878 | |