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2824 Rodgers Rd. Ste. 201 Wake Forest NC 27587 | |
(919) 435-7660 | |
Not Available |
Full Name | |
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Speciality | Dentist - Pediatric Dentistry |
Location | 2824 Rodgers Rd., Wake Forest, North Carolina |
Authorized Official Name and Position | Amena Holley (CREDENTIALING SPECIALIST) |
Authorized Official Contact | 2485505440 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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2824 Rodgers Rd. Ste. 201 Wake Forest NC 27587 Ph: () - | 2824 Rodgers Rd. Ste. 201 Wake Forest NC 27587 Ph: (919) 435-7660 |
NPI Number | 1124895354 |
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Provider Enumeration Date | 12/07/2023 |
Last Update Date | 12/12/2023 |
Identifier | Type | State | Issuer |
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1124895354 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |