| Sue A. Minneman-fowler, Dds, Pllc | |
|
1002 Jenkins Anenue Maysville NC 28555 | |
| (910) 743-2521 | |
| (910) 743-2531 |
| Full Name | Sue A. Minneman-fowler, Dds, Pllc |
|---|---|
| Speciality | Dentist |
| Location | 1002 Jenkins Anenue, Maysville, North Carolina |
| Authorized Official Name and Position | Sue Ann Minneman-fowler (PRESIDENT/OWNER) |
| Authorized Official Contact | 9107432521 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sue A. Minneman-fowler, Dds, Pllc 1002 Jenkins Avenue Maysville NC 28555-0418 Ph: (910) 743-2521 | Sue A. Minneman-fowler, Dds, Pllc 1002 Jenkins Anenue Maysville NC 28555 Ph: (910) 743-2521 |
| NPI Number | 1689016206 |
|---|---|
| Provider Enumeration Date | 07/24/2013 |
| Last Update Date | 07/24/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689016206 | NPI | - | NPPES |
| 5900050 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 5410 (North Carolina) | Primary |
Lane And Associates Xl Dds Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1002 Jenkins Ave, Maysville, NC 28555 Phone: 910-743-2521 Fax: 910-743-2531 |