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General NPI Number Information
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NPI Number | 1598247579
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Entity Type | Organization
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Legal Business Name | S. VAKIL DDS MS I, PA
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Dates
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Enumeration Date | 09/05/2018
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Last Update Date | 12/05/2022
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Provider Practice Location Address
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Address Line | 6331 CARMEL RD STE 101
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City | CHARLOTTE
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State | NC
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Zip | 28226-8246
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Country | US
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Telephone | 704-741-3070
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Fax |
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Provider Business Mailing Address
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Address Line | 308 IVERSON WAY
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City | CHARLOTTE
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State | NC
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Zip | 28203-5631
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Country | US
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Telephone | 919-357-2288
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. SHAMIK S VAKIL
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Credential | DDS, MS
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Telephone | 919-357-2288
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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 | 8667
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License Number State | NC
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