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General NPI Number Information
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NPI Number | 1427223171
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Entity Type | Organization
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Legal Business Name | VUCHNICH & BLACKER ORTHODONTICS
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Dates
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Enumeration Date | 04/24/2008
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Last Update Date | 07/07/2009
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Provider Practice Location Address
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Address Line | 1028 LEEANN DRIVE SUITE 300
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City | CONCORD
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State | NC
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Zip | 28025
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Country | US
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Telephone | 704-782-5146
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Fax | 704-784-2002
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Provider Business Mailing Address
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Address Line | 1028 LEEANN DRIVE SUITE 300
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City | CONCORD
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State | NC
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Zip | 28025
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Country | US
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Telephone | 704-782-5146
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Fax | 704-784-2002
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Authorized Official
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Title or Position | DOCTOR
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Name | MR. WALTER S. VUCHNICH
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Credential | DDS, MS, PA
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Telephone | 704-782-5146
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 5060
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License Number State | NC
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