|
| |
|
1661 Owen Dr Fayetteville NC 28304-3425 | |
| (910) 485-2273 | |
| (910) 485-0772 |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 1661 Owen Dr, Fayetteville, North Carolina |
| Authorized Official Name and Position | Kirsten Toi Inman (OFFICE MANAGER) |
| Authorized Official Contact | 9104252273 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1661 Owen Dr Fayetteville NC 28304-3425 Ph: (910) 485-2273 | 1661 Owen Dr Fayetteville NC 28304-3425 Ph: (910) 485-2273 |
| NPI Number | 1003086174 |
|---|---|
| Provider Enumeration Date | 03/05/2008 |
| Last Update Date | 10/29/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003086174 | NPI | - | NPPES |
| 767829 | Other | NC | UNITED CONCORDIA |
| 90477 | Other | NC | BLUE CROSS OF NC |
| 8990477 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 6315 (North Carolina) | Primary |
Knowles, Smith & Associates, Llp Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2409 Robeson St, Fayetteville, NC 28305 Phone: 910-483-9546 | |