Healthcare Provider Details
I. General information
NPI: 1528577780
Provider Name (Legal Business Name): PEAK ENDODONTICS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/20/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1600 OLIVE CHAPEL RD STE 100
APEX NC
27502-6765
US
IV. Provider business mailing address
1600 OLIVE CHAPEL RD STE 100
APEX NC
27502-6765
US
V. Phone/Fax
- Phone: 919-363-1419
- Fax: 919-654-6244
- Phone: 919-363-1419
- Fax: 919-654-6244
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223E0200X |
| Taxonomy | Endodontics |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name: DR.
MARIA
CRISTINA
MARESCA
Title or Position: OWNER
Credential: DDS MS
Phone: 919-363-1419