| Tracie L. Vestal Dds Pa | |
|
500 W Broad St Elizabethtown NC 28337-9411 | |
| (910) 862-4078 | |
| Not Available |
| Full Name | Tracie L. Vestal Dds Pa |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 500 W Broad St, Elizabethtown, North Carolina |
| Authorized Official Name and Position | Tracie Leigh Vestal (OWNER) |
| Authorized Official Contact | 9108624078 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tracie L. Vestal Dds Pa 500 W Broad St Elizabethtown NC 28337-9411 Ph: (910) 862-4078 | Tracie L. Vestal Dds Pa 500 W Broad St Elizabethtown NC 28337-9411 Ph: (910) 862-4078 |
| NPI Number | 1508039405 |
|---|---|
| Provider Enumeration Date | 04/11/2008 |
| Last Update Date | 03/07/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508039405 | NPI | - | NPPES |
| 7200 | Other | NC | NC LICENSE |
| 902EC | Other | NC | BCBS PROVIDER # |
| 89902EC | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 7200 (North Carolina) | Primary |
Hester And Associates Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 508 E. Mckay St., Elizabethtown, NC 28337 Phone: 252-292-1349 | |
Samuel Ray Cross Dds Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 401 Doctors Circle, Elizabethtown, NC 28337 Phone: 910-862-2892 Fax: 910-862-6345 | |
Charles D. Allen, Jr., Dds, Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 508 Mckay St, Elizabethtown, NC 28337 Phone: 910-862-4334 Fax: 910-862-3813 | |
Justin M Degarmo Dmd & Ann Hamill Greene Dds Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 401 Doctors Drive, Elizabethtown, NC 28337 Phone: 910-862-2892 Fax: 910-862-6345 |