Healthcare Provider Details

I. General information

NPI: 1316014897
Provider Name (Legal Business Name): TAMMY HARRIS SYKES CDA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 N GREENSBORO ST CARR MILL MALL SUITE D15
CARRBORO NC
27510-1833
US

IV. Provider business mailing address

300 W TRYON ST
HILLSBOROUGH NC
27278-2438
US

V. Phone/Fax

Practice location:
  • Phone: 919-968-2040
  • Fax: 919-968-2021
Mailing address:
  • Phone: 919-245-2435
  • Fax: 919-644-3368

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code126800000X
TaxonomyDental Assistant
License Number133902
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: