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General NPI Number Information
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NPI Number | 1003085895
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Entity Type | Organization
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Legal Business Name | MONIQUE D MCEACHERN DDS PLLC
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Dates
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Enumeration Date | 02/26/2008
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Last Update Date | 02/26/2008
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Provider Practice Location Address
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Address Line | 10226 COULOAK DRIVE STE 100
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City | CHARLOTTE
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State | NC
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Zip | 28216
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Country | US
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Telephone | 704-971-7272
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Fax | 704-971-7522
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Provider Business Mailing Address
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Address Line | 10226 COULOAK DRIVE STE 100
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City | CHARLOTTE
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State | NC
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Zip | 28216
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Country | US
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Telephone | 704-971-7272
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Fax | 704-971-7522
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Authorized Official
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Title or Position | ADMINISTRATIVE ASSISTANT
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Name | MRS. LEIGH ANN HARRIS
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Credential |
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Telephone | 704-971-7272
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 7458
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License Number State | NC
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