| Paul D. Nifong Jr. Ddspa | |
|
3624 Clemmons Road Clemmons NC 27012-0325 | |
| (336) 766-6457 | |
| Not Available |
| Full Name | Paul D. Nifong Jr. Ddspa |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3624 Clemmons Road, Clemmons, North Carolina |
| Authorized Official Name and Position | Paul Douglas Nifong (PRESIDENT) |
| Authorized Official Contact | 3367666457 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Paul D. Nifong Jr. Ddspa Po Box 325 Clemmons NC 27012-0325 Ph: (336) 766-6457 | Paul D. Nifong Jr. Ddspa 3624 Clemmons Road Clemmons NC 27012-0325 Ph: (336) 766-6457 |
| NPI Number | 1437160991 |
|---|---|
| Provider Enumeration Date | 08/10/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437160991 | NPI | - | NPPES |
| 8996451 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 4520 (North Carolina) | Primary |
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