| C Douglas Peedin Jr Dds | |
|
110 Professional Dr Roanoke Rapids NC 27870 | |
| (252) 537-0438 | |
| (252) 537-0438 |
| Full Name | C Douglas Peedin Jr Dds |
|---|---|
| Speciality | Dentist |
| Location | 110 Professional Dr, Roanoke Rapids, North Carolina |
| Authorized Official Name and Position | Clyde Douglas Peedin (OWNER) |
| Authorized Official Contact | 2525370438 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| C Douglas Peedin Jr Dds 110 Professional Dr Roanoke Rapids NC 27870 Ph: (252) 537-0438 | C Douglas Peedin Jr Dds 110 Professional Dr Roanoke Rapids NC 27870 Ph: (252) 537-0438 |
| NPI Number | 1992977557 |
|---|---|
| Provider Enumeration Date | 03/24/2008 |
| Last Update Date | 03/24/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992977557 | NPI | - | NPPES |
| 8996771 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 4676 (North Carolina) | Primary |
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