| Northeast Pediatric Dentistry | |
|
11223 Davinci Dr Davidson NC 28036-7799 | |
| (704) 895-6445 | |
| (704) 895-6496 |
| Full Name | Northeast Pediatric Dentistry |
|---|---|
| Speciality | Dentist |
| Location | 11223 Davinci Dr, Davidson, North Carolina |
| Authorized Official Name and Position | Brandi R Jackson (OWNER/DENTIST) |
| Authorized Official Contact | 7048956445 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northeast Pediatric Dentistry 11223 Davinci Dr Davidson NC 28036-7799 Ph: (704) 895-6445 | Northeast Pediatric Dentistry 11223 Davinci Dr Davidson NC 28036-7799 Ph: (704) 895-6445 |
| NPI Number | 1881975191 |
|---|---|
| Provider Enumeration Date | 08/31/2011 |
| Last Update Date | 08/31/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881975191 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 8224 (North Carolina) | Primary |
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