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General NPI Number Information
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NPI Number | 1114368545
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Entity Type | Organization
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Legal Business Name | JAMES R. CANNON JR., DDS, PA
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Dates
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Enumeration Date | 07/15/2013
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Last Update Date | 06/18/2014
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Provider Practice Location Address
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Address Line | 401 6TH AVE W
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City | HENDERSONVILLE
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State | NC
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Zip | 28739-4209
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Country | US
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Telephone | 828-697-7500
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Fax | 828-697-7507
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Provider Business Mailing Address
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Address Line | 401 6TH AVE W
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City | HENDERSONVILLE
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State | NC
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Zip | 28739-4209
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Country | US
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Telephone | 828-697-7500
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Fax | 828-697-7507
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Authorized Official
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Title or Position | OWNER
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Name | JAMES R CANNON JR.
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Credential | DDS
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Telephone | 828-697-7500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 7916
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License Number State | NC
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