Healthcare Provider Details

I. General information

NPI: 1245067966
Provider Name (Legal Business Name): PRISCILLA CARDOSO LAZARI CARVALHO MS, PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2024
Last Update Date: 09/17/2024
Certification Date: 09/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNC ADAMS SCHOOL OF DENTISTRY CAMPUS BOX #7450
CHAPEL HILL NC
27599-0001
US

IV. Provider business mailing address

UNC ADAMS SCHOOL OF DENTISTRY CAMPUS BOX #7450
CHAPEL HILL NC
27599-0001
US

V. Phone/Fax

Practice location:
  • Phone: 919-537-3726
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number0289
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: