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General NPI Number Information
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NPI Number | 1295897692
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Entity Type | Organization
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Legal Business Name | KALONS AND GLIDEWELL DDS PA
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Dates
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Enumeration Date | 12/14/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 201 S COLLEGE ST SUITE 1465
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City | CHARLOTTE
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State | NC
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Zip | 28244-0002
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Country | US
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Telephone | 704-378-6591
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Fax |
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Provider Business Mailing Address
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Address Line | 201 S COLLEGE ST SUITE 1465
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City | CHARLOTTE
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State | NC
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Zip | 28244-0002
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Country | US
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Telephone | 704-378-6591
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KRISTI NA GLIDEWELL
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Credential |
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Telephone | 704-378-6591
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 7176
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License Number State | NC
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