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505 N Main St Creedmoor NC 27522-8846 | |
| (919) 528-8700 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 505 N Main St, Creedmoor, North Carolina |
| Authorized Official Name and Position | Donghoon Lee (PRESIDENT) |
| Authorized Official Contact | 9194953589 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
505 N Main St Creedmoor NC 27522-8846 Ph: (919) 528-8700 | 505 N Main St Creedmoor NC 27522-8846 Ph: (919) 528-8700 |
| NPI Number | 1558773168 |
|---|---|
| Provider Enumeration Date | 06/02/2014 |
| Last Update Date | 06/02/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558773168 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 9417 (North Carolina) | Primary |
Kenneth R Marsh Dds Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1582 Hwy 56, Creedmoor, NC 27522 Phone: 919-528-1980 Fax: 919-528-8610 | |