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General NPI Number Information
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NPI Number | 1124175351
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Entity Type | Organization
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Legal Business Name | GARY E. MCCORD D.D.S., P.A.
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Dates
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Enumeration Date | 01/03/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1215 SPRUCE ST
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City | BELMONT
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State | NC
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Zip | 28012-3371
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Country | US
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Telephone | 704-825-5111
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Fax | 704-825-5113
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Provider Business Mailing Address
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Address Line | 1215 SPRUCE ST
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City | BELMONT
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State | NC
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Zip | 28012-3371
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Country | US
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Telephone | 704-825-5111
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Fax | 704-825-5113
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GARY EDWARD MCCORD
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Credential | D.M.D
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Telephone | 704-825-5111
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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 | 4861
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License Number State | NC
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