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General NPI Number Information
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NPI Number | 1023791407
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Entity Type | Organization
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Legal Business Name | OLUFUNMILOLA AKINYEMI, DMD, PLLC
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Dates
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Enumeration Date | 08/10/2023
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Last Update Date | 08/10/2023
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Provider Practice Location Address
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Address Line | 9609 E INDEPENDENCE BLVD STE V
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City | MATTHEWS
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State | NC
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Zip | 28105-4670
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Country | US
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Telephone | 704-771-1544
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Fax | 704-771-1333
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Provider Business Mailing Address
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Address Line | 2013 BLUE RANGE RD
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City | INDIAN TRAIL
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State | NC
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Zip | 28079-8487
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Country | US
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Telephone | 859-684-4740
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. OLUFUNMILOLA AKINYEMI
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Credential | DMD
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Telephone | 859-684-4740
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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