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General NPI Number Information
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NPI Number | 1326363094
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Entity Type | Organization
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Legal Business Name | BROOKS DUNSTON DDS PLLC
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Dates
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Enumeration Date | 04/06/2010
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Last Update Date | 06/10/2010
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Provider Practice Location Address
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Address Line | 55 AMARILLO LANE BUFFALO LAKE BUSINESS PARK
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City | SANFORD
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State | NC
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Zip | 27332
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Country | US
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Telephone | 919-499-9950
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Fax |
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Provider Business Mailing Address
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Address Line | 55 AMARILLO LANE
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City | SANFORD
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State | NC
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Zip | 27332
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Country | US
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Telephone | 919-499-9950
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Fax |
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Authorized Official
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Title or Position | COOWNER
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Name | DR. SIDNEY ALAN BROOKS SR.
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Credential | DDS
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Telephone | 919-499-9950
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 8090
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 7683
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License Number State | NC
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