Healthcare Provider Details

I. General information

NPI: 1841323169
Provider Name (Legal Business Name): WAYNE COUNTY HEALTH DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 N HERMAN ST SUITE CC
GOLDSBORO NC
27530-2973
US

IV. Provider business mailing address

368 TEELS ESTATE RD
GREENVILLE NC
27834-9285
US

V. Phone/Fax

Practice location:
  • Phone: 919-705-1931
  • Fax:
Mailing address:
  • Phone: 252-902-7068
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number7093
License Number StateNC

VIII. Authorized Official

Name: DR. TIFFINEY TYLAINE HARPER
Title or Position: DENTAL DIRECTOR
Credential: DDS
Phone: 919-705-1931