Provider Demographics
NPI:1295170330
Name:GREATER CHARLOTTE ORAL & FACIAL SURGERY
Entity type:Organization
Organization Name:GREATER CHARLOTTE ORAL & FACIAL SURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AMIR
Authorized Official - Middle Name:H
Authorized Official - Last Name:MARASHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD,DDS
Authorized Official - Phone:980-939-1400
Mailing Address - Street 1:10935 WINDS CROSSING DR
Mailing Address - Street 2:SUITE 400
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28273-2402
Mailing Address - Country:US
Mailing Address - Phone:980-939-1400
Mailing Address - Fax:980-939-1460
Practice Address - Street 1:10935 WINDS CROSSING DR
Practice Address - Street 2:SUITE 400
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28273-2402
Practice Address - Country:US
Practice Address - Phone:980-939-1400
Practice Address - Fax:980-939-1460
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-02
Last Update Date:2014-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC01124261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty