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312 W Mclean St Saint Pauls NC 28384-1726 | |
(910) 865-5188 | |
(910) 865-3015 |
Full Name | |
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Speciality | Dentist |
Location | 312 W Mclean St, Saint Pauls, North Carolina |
Authorized Official Name and Position | Michael John Knowles (OWNER) |
Authorized Official Contact | 9104858884 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 365 Saint Pauls NC 28384-0365 Ph: (910) 865-5188 | 312 W Mclean St Saint Pauls NC 28384-1726 Ph: (910) 865-5188 |
NPI Number | 1689788366 |
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Provider Enumeration Date | 08/18/2006 |
Last Update Date | 02/25/2015 |
Identifier | Type | State | Issuer |
---|---|---|---|
1689788366 | NPI | - | NPPES |
890203G | Medicaid | NC |
Taxonomy | Type | License (State) | Status |
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122300000X | Dentist | (* (Not Available)) | Primary |