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General NPI Number Information
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NPI Number | 1083828198
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Entity Type | Organization
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Legal Business Name | GURLEY, HALL, RITTER, AND BROGDEN D.D.S, M.S., P.A.
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Dates
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Enumeration Date | 05/09/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1144 EXECUTIVE CIR
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City | CARY
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State | NC
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Zip | 27511-4573
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Country | US
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Telephone | 919-467-2419
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Fax | 919-467-9162
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Provider Business Mailing Address
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Address Line | 1144 EXECUTIVE CIR
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City | CARY
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State | NC
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Zip | 27511-4573
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Country | US
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Telephone | 919-467-2419
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Fax | 919-467-9162
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. REID H BROGDEN
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Credential |
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Telephone | 919-467-2419
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 6869
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 6799
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 3555
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License Number State | NC
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