Provider Demographics
NPI:1184353799
Name:ASPIRE DENTAL WELLNESS
Entity type:Organization
Organization Name:ASPIRE DENTAL WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:LEVINGSTON
Authorized Official - Last Name:PEETERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-701-7104
Mailing Address - Street 1:2701 COLTSGATE RD STE 104
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28211-3581
Mailing Address - Country:US
Mailing Address - Phone:980-999-4399
Mailing Address - Fax:980-224-2336
Practice Address - Street 1:2701 COLTSGATE RD STE 104
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-3581
Practice Address - Country:US
Practice Address - Phone:980-999-4399
Practice Address - Fax:980-224-2336
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SLADJANA BJELAC DDS PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-06-08
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty