Healthcare Provider Details

I. General information

NPI: 1932399987
Provider Name (Legal Business Name): GEORGE F PINSAK, DMD, MSD, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2007
Last Update Date: 07/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1102 E FRANKLIN ST
MONROE NC
28112-5028
US

IV. Provider business mailing address

1102 E FRANKLIN ST
MONROE NC
28112-5028
US

V. Phone/Fax

Practice location:
  • Phone: 704-289-9473
  • Fax: 704-283-9185
Mailing address:
  • Phone: 704-289-9473
  • Fax: 704-283-9185

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number3709
License Number StateNC

VIII. Authorized Official

Name: CAROL H. PINSAK
Title or Position: ADMIN. ASSISTANT
Credential:
Phone: 704-289-9473