|
| |
|
2409 Robeson St Fayetteville NC 28305-5549 | |
| (910) 483-9546 | |
| (910) 483-8550 |
| Full Name | |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 2409 Robeson St, Fayetteville, North Carolina |
| Authorized Official Name and Position | Larry Tabatchnick (OWNER) |
| Authorized Official Contact | 9104839546 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2409 Robeson St Fayetteville NC 28305-5549 Ph: (910) 483-9546 | 2409 Robeson St Fayetteville NC 28305-5549 Ph: (910) 483-9546 |
| NPI Number | 1558597971 |
|---|---|
| Provider Enumeration Date | 06/01/2009 |
| Last Update Date | 06/01/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558597971 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 8750 (North Carolina) | Primary |
Knowles, Smith & Associates, Llp Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2409 Robeson St, Fayetteville, NC 28305 Phone: 910-483-9546 | |