Healthcare Provider Details

I. General information

NPI: 1922208263
Provider Name (Legal Business Name): WILSON S HOYLE JR DDS PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2007
Last Update Date: 08/23/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

519 S CHESTNUT ST
HENDERSON NC
27536
US

IV. Provider business mailing address

PO BOX 1455
HENDERSON NC
27536
US

V. Phone/Fax

Practice location:
  • Phone: 252-492-2897
  • Fax:
Mailing address:
  • Phone: 252-438-8512
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number3280
License Number StateNC

VIII. Authorized Official

Name: DR. WILSON S HOYLE JR.
Title or Position: DENTIST OWNER
Credential: DDS
Phone: 252-492-2897