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2350 Bentridge Ln Fayetteville NC 28304-0590 | |
(919) 977-0627 | |
Not Available |
Full Name | |
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Speciality | Dentist - Pediatric Dentistry |
Location | 2350 Bentridge Ln, Fayetteville, North Carolina |
Authorized Official Name and Position | Amena Holley (CREDENTIALING SPECILIAST) |
Authorized Official Contact | 2485505440 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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2350 Bentridge Ln Fayetteville NC 28304-0590 Ph: (248) 550-5440 | 2350 Bentridge Ln Fayetteville NC 28304-0590 Ph: (919) 977-0627 |
NPI Number | 1710692918 |
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Provider Enumeration Date | 01/23/2023 |
Last Update Date | 01/25/2023 |
Identifier | Type | State | Issuer |
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1710692918 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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122300000X | Dentist | (* (Not Available)) | Secondary |
1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
Knowles, Smith & Associates, Llp Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2409 Robeson St, Fayetteville, NC 28305 Phone: 910-483-9546 | |