Healthcare Provider Details

I. General information

NPI: 1821473836
Provider Name (Legal Business Name): ROMA MISLANKAR DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2015
Last Update Date: 07/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11180 E FINCH AVE
MIDDLESEX NC
27557-7440
US

IV. Provider business mailing address

204 BELL ARTHUR DR
CARY NC
27519-6120
US

V. Phone/Fax

Practice location:
  • Phone: 252-235-0491
  • Fax: 252-235-0497
Mailing address:
  • Phone: 919-387-0139
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number10138
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: