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222 Fairway Dr Fayetteville NC 28305-5512 | |
(910) 484-8191 | |
(910) 484-0502 |
Full Name | |
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Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
Location | 222 Fairway Dr, Fayetteville, North Carolina |
Authorized Official Name and Position | Frederick A Booth (ORTHODONTIST) |
Authorized Official Contact | 9104848191 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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222 Fairway Dr Fayetteville NC 28305-5512 Ph: (910) 484-8191 | 222 Fairway Dr Fayetteville NC 28305-5512 Ph: (910) 484-8191 |
NPI Number | 1508047804 |
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Provider Enumeration Date | 11/15/2007 |
Last Update Date | 06/18/2008 |
Identifier | Type | State | Issuer |
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1508047804 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 3650 (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 | |