| Anthony R. Immediata, D.m.d, P.a. | |
|
7101 Creedmoor Rd Suite 109 Raleigh NC 27613-1682 | |
| (919) 846-5500 | |
| (919) 846-7964 |
| Full Name | Anthony R. Immediata, D.m.d, P.a. |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 7101 Creedmoor Rd, Raleigh, North Carolina |
| Authorized Official Name and Position | Barbara Sed (OFFICE MANAGER) |
| Authorized Official Contact | 9198465500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Anthony R. Immediata, D.m.d, P.a. 7101 Creedmoor Rd Suite 109 Raleigh NC 27613-1682 Ph: (919) 846-5500 | Anthony R. Immediata, D.m.d, P.a. 7101 Creedmoor Rd Suite 109 Raleigh NC 27613-1682 Ph: (919) 846-5500 |
| NPI Number | 1861643678 |
|---|---|
| Provider Enumeration Date | 10/10/2008 |
| Last Update Date | 12/03/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861643678 | NPI | - | NPPES |
| 8994426 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 5022 (North Carolina) | Primary |
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