Healthcare Provider Details

I. General information

NPI: 1285392811
Provider Name (Legal Business Name): THOMAS R COVINGTON, DDS, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2021
Last Update Date: 12/09/2021
Certification Date: 12/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1516 DOCTORS CIR
WILMINGTON NC
28401-7404
US

IV. Provider business mailing address

1516 DOCTORS CIR
WILMINGTON NC
28401-7404
US

V. Phone/Fax

Practice location:
  • Phone: 910-251-1100
  • Fax: 910-251-9871
Mailing address:
  • Phone: 910-251-1100
  • Fax: 910-251-9871

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. MARY WEBB
Title or Position: FINANCIAL COORDINATOR
Credential:
Phone: 910-251-1100