Healthcare Provider Details

I. General information

NPI: 1548945009
Provider Name (Legal Business Name): ALLISON NICOLE DREYER DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2023
Last Update Date: 07/06/2023
Certification Date: 07/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

736 MEDICAL CENTER DR STE 101
WILMINGTON NC
28401-4284
US

IV. Provider business mailing address

4037 WATERCRAFT FERRY AVE UNIT 310
WILMINGTON NC
28412-6279
US

V. Phone/Fax

Practice location:
  • Phone: 910-502-9476
  • Fax:
Mailing address:
  • Phone: 847-373-6892
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number13359
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: