| Durham Family Dentistry | |
|
1200 Broad St Ste 300 Durham NC 27705-3573 | |
| (919) 286-6646 | |
| (919) 286-6668 |
| Full Name | Durham Family Dentistry |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1200 Broad St Ste 300, Durham, North Carolina |
| Authorized Official Name and Position | Alicia Duffy (CREDENTIALING MANAGER) |
| Authorized Official Contact | 9192952757 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Durham Family Dentistry 1200 Broad St Ste 300 Durham NC 27705-3573 Ph: (919) 286-6646 | Durham Family Dentistry 1200 Broad St Ste 300 Durham NC 27705-3573 Ph: (919) 286-6646 |
| NPI Number | 1629122528 |
|---|---|
| Provider Enumeration Date | 01/22/2007 |
| Last Update Date | 04/04/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629122528 | NPI | - | NPPES |
| 89016TG | Medicaid | NC | |
| 016YU | Other | NC | BCBS-NC HEALTHCHOICE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 4785 (North Carolina) | Primary |
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