Healthcare Provider Details

I. General information

NPI: 1023959004
Provider Name (Legal Business Name): MOHS DDS NORTH CAROLINA PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2026
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

206 W MILLBROOK RD
RALEIGH NC
27609-4304
US

IV. Provider business mailing address

206 W MILLBROOK RD
RALEIGH NC
27609-4304
US

V. Phone/Fax

Practice location:
  • Phone: 919-578-9973
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: AUSTIN MOHS
Title or Position: OWNER, PARTNER
Credential: DDS
Phone: 919-578-9973