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105 Perry Dr Southern Pines NC 28387-7019 | |
(910) 692-5111 | |
(910) 692-1003 |
Full Name | |
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Speciality | Clinic/center - Dental |
Location | 105 Perry Dr, Southern Pines, North Carolina |
Authorized Official Name and Position | Mickey Foster (CEO) |
Authorized Official Contact | 9107154473 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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105 Perry Dr Southern Pines NC 28387-7019 Ph: (910) 692-5111 | 105 Perry Dr Southern Pines NC 28387-7019 Ph: (910) 692-5111 |
NPI Number | 1699755686 |
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Provider Enumeration Date | 01/18/2006 |
Last Update Date | 12/04/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1699755686 | NPI | - | NPPES |
0296V | Other | NC | BCBS |
89-0296V | Medicaid | NC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QD0000X | Clinic/center - Dental | H0100 (North Carolina) | Primary |
Dr. Jason Graves And Associates Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 Pavilion Way Ste G, Southern Pines, NC 28387 Phone: 910-684-3687 Fax: 910-401-1918 | |
Lane And Associates Xxx, Dds Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 10677 Us 15 501 Hwy Ste 100, Southern Pines, NC 28387 Phone: 910-295-5980 Fax: 910-295-3593 | |