Provider Demographics
NPI:1871295220
Name:RFDEST, DDS PLLC
Entity type:Organization
Organization Name:RFDEST, DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:EILEEN
Authorized Official - Middle Name:R
Authorized Official - Last Name:CHILDERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-790-4410
Mailing Address - Street 1:8301 UNIVERSITY EXEC PARK DR STE 105
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262-3378
Mailing Address - Country:US
Mailing Address - Phone:704-790-4410
Mailing Address - Fax:704-228-8481
Practice Address - Street 1:910 DONTIA DR
Practice Address - Street 2:
Practice Address - City:LINCOLNTON
Practice Address - State:NC
Practice Address - Zip Code:28092-3643
Practice Address - Country:US
Practice Address - Phone:980-284-2108
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RFDEST,DDS PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty