Healthcare Provider Details

I. General information

NPI: 1528397619
Provider Name (Legal Business Name): REBECCA SYKES D.D.S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2009
Last Update Date: 12/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

270 S BENNETT ST
SOUTHERN PINES NC
28387-5402
US

IV. Provider business mailing address

270 S BENNETT ST
SOUTHERN PINES NC
28387-5402
US

V. Phone/Fax

Practice location:
  • Phone: 910-695-1300
  • Fax:
Mailing address:
  • Phone: 910-695-1300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number8777
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: