NPI 1003502519

South Park Oral Surgery

Organisation Oral and Maxillofacial Surgery (Dentist) Charlotte, NC

Practice location

Address: 2719 Coltsgate Rd, Charlotte, NC 28211-3502
Phone: (704) 366-8707
Fax: (704) 366-8717

Authorised official

Name: Kevin P Bond
Title: Dentist/Owner
Phone: (704) 366-8707

Registered specialties

Oral and Maxillofacial Surgery (Dentist) Primary

Dental Providers Taxonomy 1223S0112X

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Registry record

NPI: 1003502519
Entity type: Organization
NPI issued: 17 Apr 2023
Record last updated: 17 Apr 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.