| Heritage Aesthetic Dentistry | |
|
3205 Rogers Rd Wake Forest NC 27587-3805 | |
| (909) 453-2300 | |
| (919) 453-2301 |
| Full Name | Heritage Aesthetic Dentistry |
|---|---|
| Speciality | Dentist |
| Location | 3205 Rogers Rd, Wake Forest, North Carolina |
| Authorized Official Name and Position | Kim R Melton (PRESIDENT) |
| Authorized Official Contact | 9194532300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Heritage Aesthetic Dentistry 3205 Rogers Rd Wake Forest NC 27587-3805 Ph: (909) 453-2300 | Heritage Aesthetic Dentistry 3205 Rogers Rd Wake Forest NC 27587-3805 Ph: (909) 453-2300 |
| NPI Number | 1679788202 |
|---|---|
| Provider Enumeration Date | 05/14/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679788202 | NPI | - | NPPES |
| 8990174 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 7307 (North Carolina) | Primary |
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