Healthcare Provider Details

I. General information

NPI: 1932297728
Provider Name (Legal Business Name): NORMAN JOSEPH SYKES JR. D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 07/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

475 N WENDOVER RD
CHARLOTTE NC
28211-1064
US

IV. Provider business mailing address

475 N WENDOVER RD
CHARLOTTE NC
28211-1064
US

V. Phone/Fax

Practice location:
  • Phone: 704-365-6811
  • Fax: 704-365-6791
Mailing address:
  • Phone: 704-365-6811
  • Fax: 704-365-6791

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number5881
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: