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2824 Rogers Rd Ste 103 Wake Forest NC 27587-3896 | |
(919) 554-4588 | |
Not Available |
Full Name | |
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Speciality | Dentist - General Practice |
Location | 2824 Rogers Rd Ste 103, Wake Forest, North Carolina |
Authorized Official Name and Position | Belinda Huerta (CREDENTIALING COORDINATOR) |
Authorized Official Contact | 2175402100 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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2824 Rogers Rd Ste 103 Wake Forest NC 27587-3896 Ph: (919) 554-4588 | 2824 Rogers Rd Ste 103 Wake Forest NC 27587-3896 Ph: (919) 554-4588 |
NPI Number | 1063165793 |
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Provider Enumeration Date | 02/02/2022 |
Last Update Date | 10/04/2024 |
Identifier | Type | State | Issuer |
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1063165793 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |