| James D Douglass Dds Pa | |
|
101 Wall St Fayetteville NC 28301-4761 | |
| (910) 323-8254 | |
| (910) 323-2532 |
| Full Name | James D Douglass Dds Pa |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 101 Wall St, Fayetteville, North Carolina |
| Authorized Official Name and Position | James Davis Douglass (OWNER) |
| Authorized Official Contact | 9103238254 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| James D Douglass Dds Pa Po Box 1449 Fayetteville NC 28302-1449 Ph: (910) 323-8254 | James D Douglass Dds Pa 101 Wall St Fayetteville NC 28301-4761 Ph: (910) 323-8254 |
| NPI Number | 1306902416 |
|---|---|
| Provider Enumeration Date | 01/01/2007 |
| Last Update Date | 09/09/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306902416 | NPI | - | NPPES |
| 5950576 | Medicaid | NC | |
| 809135 | Other | NC | UNITED CONCORDIA |
| 92191 | Other | NC | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 3344 (North Carolina) | Primary |
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