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General NPI Number Information
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NPI Number | 1730994146
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Entity Type | Organization
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Legal Business Name | AGUNWAH, S. DDS PLLC
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Dates
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Enumeration Date | 02/12/2025
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Last Update Date | 08/14/2025
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Provider Practice Location Address
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Address Line | 2012 BEATTIES FORD RD
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City | CHARLOTTE
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State | NC
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Zip | 28216-4514
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Country | US
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Telephone | 704-412-2444
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Fax | 704-412-2442
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Provider Business Mailing Address
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Address Line | 2012 BEATTIES FORD RD
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City | CHARLOTTE
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State | NC
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Zip | 28216-4514
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Country | US
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Telephone | 704-649-3188
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. SOMTOCHUKWU AGUNWAH
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Credential | DDS
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Telephone | 704-412-2444
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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 |
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License Number State |
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