Southland Dental Care | |
522 S Norwood St Wallace NC 28466-1620 | |
(910) 285-7800 | |
(910) 285-6097 |
Full Name | Southland Dental Care |
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Speciality | Dentist - General Practice |
Location | 522 S Norwood St, Wallace, North Carolina |
Authorized Official Name and Position | Axon Darren Sholar (PRESIDENT/OWNDER) |
Authorized Official Contact | 9102857800 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Southland Dental Care 522 S Norwood St Wallace NC 28466-1620 Ph: (910) 285-7800 | Southland Dental Care 522 S Norwood St Wallace NC 28466-1620 Ph: (910) 285-7800 |
NPI Number | 1053561555 |
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Provider Enumeration Date | 09/22/2008 |
Last Update Date | 06/11/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1053561555 | NPI | - | NPPES |
1680308 | Other | NC | UNITED CONCORDIA |
97800 | Other | NC | BCBS |
385397 | Other | NC | TRIGON |
8997800 | Medicaid | NC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | 6268 (North Carolina) | Primary |