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General NPI Number Information
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NPI Number | 1265632327
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Entity Type | Organization
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Legal Business Name | CHRISTOPHER G. KAKAVAS, DDS, PA
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Dates
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Enumeration Date | 07/18/2007
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Last Update Date | 07/18/2007
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Provider Practice Location Address
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Address Line | 306 ALAMANCE RD A
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City | BURLINGTON
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State | NC
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Zip | 27215-5683
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Country | US
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Telephone | 336-228-1014
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1237
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City | BURLINGTON
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State | NC
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Zip | 27216-1237
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | CHRISTOPHER KAKAVAS
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Credential |
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Telephone | 336-228-1014
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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 | 0729
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License Number State | NC
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