Healthcare Provider Details

I. General information

NPI: 1922182922
Provider Name (Legal Business Name): NANCY R. CHAFFEE, D.D.S., M.S., P.L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 09/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 W WILLIAMS ST
APEX NC
27502-1846
US

IV. Provider business mailing address

500 W WILLIAMS ST
APEX NC
27502-1846
US

V. Phone/Fax

Practice location:
  • Phone: 919-387-4775
  • Fax: 919-387-9559
Mailing address:
  • Phone: 919-387-4775
  • Fax: 919-387-9559

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number7259
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. NANCY RAE CHAFFEE
Title or Position: OWNER
Credential: D.D.S., M.S.
Phone: 919-387-4775