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General NPI Number Information
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NPI Number | 1073821948
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Entity Type | Organization
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Legal Business Name | MARCIA L REMENTER DMD, P.A. IV
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Dates
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Enumeration Date | 09/14/2010
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Last Update Date | 09/14/2010
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Provider Practice Location Address
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Address Line | 2601 OAKCREST AVE STE D 2601F OAKCREST AVE.
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City | GREENSBORO
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State | NC
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Zip | 27408-4719
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Country | US
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Telephone | 336-288-7704
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Fax |
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Provider Business Mailing Address
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Address Line | 2601 OAKCREST AVE STE D 2601F OAKCREST AVE.
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City | GREENSBORO
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State | NC
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Zip | 27408-4719
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Country | US
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Telephone | 336-288-7704
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. MARIA I HENDERSON
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Credential |
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Telephone | 336-260-7156
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 5456
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License Number State | NC
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