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General NPI Number Information
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NPI Number | 1134828643
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Entity Type | Organization
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Legal Business Name | BETANCOURT & PINNIX PLLC
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Dates
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Enumeration Date | 02/23/2023
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Last Update Date | 02/23/2023
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Provider Practice Location Address
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Address Line | 15033 BALLANCROFT PKWY STE 102
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City | CHARLOTTE
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State | NC
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Zip | 28277-4959
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Country | US
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Telephone | 704-771-1371
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Fax |
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Provider Business Mailing Address
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Address Line | 801 MEDALLION DR
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City | WAXHAW
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State | NC
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Zip | 28173-9961
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Country | US
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Telephone | 704-609-7143
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DR. GEORGE ALEXANDER BETANCOURT
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Credential | DMD
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Telephone | 704-609-7143
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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