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General NPI Number Information
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NPI Number | 1689849325
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Entity Type | Organization
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Legal Business Name | SUZANNE E BIRD DDS MS PA
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Dates
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Enumeration Date | 04/24/2008
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Last Update Date | 11/14/2013
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Provider Practice Location Address
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Address Line | 16607 RIVERSTONE WAY SUITE 300
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City | CHARLOTTE
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State | NC
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Zip | 28277-5746
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Country | US
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Telephone | 704-840-6803
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Fax |
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Provider Business Mailing Address
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Address Line | 16607 RIVERSTONE WAY SUITE 300
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City | CHARLOTTE
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State | NC
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Zip | 28277-5746
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Country | US
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Telephone | 704-840-6803
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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. SUZANNE E BIRD
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Credential | DDS MS
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Telephone | 704-840-6803
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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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