IndividualActive
Tashana Detwiler, DMD
NPI 1205500147 · Public Health Dentistry · Concord, NC
Provider details
- NPI number
- 1205500147
- Entity type
- Individual
- Primary specialty
- Public Health DentistryDental Providers
- Credential
- DMD
- Sex
- Female
- Sole proprietor
- Yes
- License
- 12420 (NC)
Specialties & taxonomies
Dental Providers
Practice location
280 Concord Pkwy S Ste 110a
Concord, NC 28027-2704
Phone: (704) 920-1070
Fax: (704) 920-1071
Approximate (ZIP-level) locationGet directions
Mailing address
5008 Shadow Pine Dr
Charlotte, NC 28269-5142
Registry dates
- Enumerated
- 2021-08-04
- Last updated
- 2021-08-04
- Certified
- 2021-08-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.