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1031 Weiss Ave Fayetteville NC 28305-5630 | |
(910) 486-4180 | |
(910) 486-4188 |
Full Name | |
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Speciality | Dentist |
Location | 1031 Weiss Ave, Fayetteville, North Carolina |
Authorized Official Name and Position | Michael John Knowles (OWNER) |
Authorized Official Contact | 9104858884 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1031 Weiss Ave Fayetteville NC 28305-5630 Ph: (910) 486-4180 | 1031 Weiss Ave Fayetteville NC 28305-5630 Ph: (910) 486-4180 |
NPI Number | 1275647976 |
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Provider Enumeration Date | 08/18/2006 |
Last Update Date | 02/25/2015 |
Identifier | Type | State | Issuer |
---|---|---|---|
1275647976 | NPI | - | NPPES |
5902198 | Medicaid | NC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | (* (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 | |