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General NPI Number Information
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NPI Number | 1164947552
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Entity Type | Organization
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Legal Business Name | JAMES WOODFORD, DDS
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Dates
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Enumeration Date | 08/07/2017
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Last Update Date | 08/07/2017
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Provider Practice Location Address
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Address Line | 2550 RAVENHILL DR STE 101
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City | FAYETTEVILLE
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State | NC
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Zip | 28303-9628
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Country | US
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Telephone | 910-486-5511
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Fax | 910-223-7359
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Provider Business Mailing Address
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Address Line | PO BOX 87214
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City | FAYETTEVILLE
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State | NC
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Zip | 28304-7214
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Country | US
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Telephone | 910-486-5511
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Fax | 910-223-7359
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Authorized Official
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Title or Position | DENTIST
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Name | DR. JAMES WILSON WOODFORD
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Credential | DDS
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Telephone | 910-486-5511
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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 | 5466
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License Number State | NC
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