| Bladenboro Family Dentistry | |
|
104 Fourth St Bladenboro NC 28320 | |
| (910) 863-2377 | |
| (910) 863-2555 |
| Full Name | Bladenboro Family Dentistry |
|---|---|
| Speciality | Dentist |
| Location | 104 Fourth St, Bladenboro, North Carolina |
| Authorized Official Name and Position | Christopher J Clark (OWNER) |
| Authorized Official Contact | 9108632377 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bladenboro Family Dentistry 104 Fourth St Bladenboro NC 28320 Ph: (910) 863-2377 | Bladenboro Family Dentistry 104 Fourth St Bladenboro NC 28320 Ph: (910) 863-2377 |
| NPI Number | 1255506861 |
|---|---|
| Provider Enumeration Date | 04/24/2008 |
| Last Update Date | 04/24/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255506861 | NPI | - | NPPES |
| 5903289 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 7917 (North Carolina) | Primary |
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 8366 (North Carolina) | Secondary |
Clark, Hays And Associates, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 104 Fourth St, Bladenboro, NC 28320 Phone: 910-863-2377 Fax: 910-863-2555 | |
Fuller & Associates Vi Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 104 4th St, Bladenboro, NC 28320 Phone: 910-863-2377 Fax: 910-863-2555 |