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13700 Capital Blvd Wake Forest NC 27587-6609 | |
(984) 235-0047 | |
Not Available |
Full Name | |
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Speciality | Dentist - General Practice |
Location | 13700 Capital Blvd, Wake Forest, North Carolina |
Authorized Official Name and Position | Celia Hayes (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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13700 Capital Blvd Wake Forest NC 27587-6609 Ph: (984) 235-0047 | 13700 Capital Blvd Wake Forest NC 27587-6609 Ph: (984) 235-0047 |
NPI Number | 1881266997 |
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Provider Enumeration Date | 07/16/2021 |
Last Update Date | 10/04/2024 |
Identifier | Type | State | Issuer |
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1881266997 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |