|
| |
|
711 Roanoke Ave Elizabeth City NC 27909-5643 | |
| (252) 338-4404 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Public Health, State Or Local |
| Location | 711 Roanoke Ave, Elizabeth City, North Carolina |
| Authorized Official Name and Position | Jerry L Parks (HEALTH DIRECTOR) |
| Authorized Official Contact | 2523384404 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 189 Elizabeth City NC 27907-0189 Ph: () - | 711 Roanoke Ave Elizabeth City NC 27909-5643 Ph: (252) 338-4404 |
| NPI Number | 1467536920 |
|---|---|
| Provider Enumeration Date | 10/24/2006 |
| Last Update Date | 01/14/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467536920 | NPI | - | NPPES |
| 3404408 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Secondary |
| 261QP0905X | Clinic/center - Public Health, State Or Local | (* (Not Available)) | Primary |
Tidal Smiles Pediatric Dentistry Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1755 City Center Blvd Unit B-2, Elizabeth City, NC 27909 Phone: 252-251-7900 | |
Thompson & Gray, Dds, Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 905 Halstead Blvd, Elizabeth City, NC 27909 Phone: 252-335-4341 | |
Leslie Treherne-fayton Dds Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3875 Conlon Way Ste A, Elizabeth City, NC 27909 Phone: 315-454-6000 | |
Scott C Blanchard Dds Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 N Water St, Elizabeth City, NC 27909 Phone: 252-335-4332 Fax: 252-335-2783 | |