Healthcare Provider Details

I. General information

NPI: 1083829428
Provider Name (Legal Business Name): H. HOWARD WEEKS, DDS, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2007
Last Update Date: 09/28/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

615 EAST NASH STREET
SPRING HOPE NC
27882-0460
US

IV. Provider business mailing address

PO BOX 460 615 EAST NASH STREET
SPRING HOPE NC
27882-0460
US

V. Phone/Fax

Practice location:
  • Phone: 252-478-3422
  • Fax: 252-478-5445
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number5114
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier8999061
Identifier TypeMEDICAID
Identifier StateNC
Identifier Issuer

VIII. Authorized Official

Name: DR. HASSELL HOWARD WEEKS III
Title or Position: CORPORATE OFFICER
Credential: DDS
Phone: 252-478-3422