Lake Wylie Modern Dentistry, PC

NPI #1194376491 in Lake Wylie, South Carolina

Provider Information

NPI Number: 1194376491
Entity Type: Organization
Organization Name: Lake Wylie Modern Dentistry, PC
Primary Specialty: Dentist
Enumeration Date: Sep 27, 2019
Last Updated: Jun 14, 2022

Practice Location

Address: 140 HIGHWAY 274
City: Lake Wylie
State: South Carolina
ZIP Code: 29710-6045
Phone: (803) 752-0565

Authorized Official

Name: DR. ALI SHAHRESTANI, DMD
Title: OWNER
Phone: (803) 752-0565

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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DR. Stacy L Blackmon, DDS	Dentist	Lake Wylie	AI Deep Dive
DR. Thomas N Stall SR., DMD	Dentist	Lake Wylie	AI Deep Dive
DR. Christopher Andrew Snell, D.D.S.	Dentist	Lake Wylie	AI Deep Dive
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Lake Wylie Family Dentistry PA	Dentist	Lake Wylie	AI Deep Dive

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