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General NPI Number Information
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NPI Number | 1376513622
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Entity Type | Organization
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Legal Business Name | FIRSTHEALTH DENTAL CARE CENTER
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Dates
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Enumeration Date | 01/26/2006
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Last Update Date | 12/04/2024
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Provider Practice Location Address
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Address Line | 314 TEAL DR
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City | RAEFORD
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State | NC
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Zip | 28376-2528
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Country | US
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Telephone | 910-904-7450
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Fax | 910-904-7474
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Provider Business Mailing Address
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Address Line | 314 TEAL DR
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City | RAEFORD
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State | NC
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Zip | 28376-2528
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Country | US
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Telephone | 910-904-7450
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Fax | 910-904-7474
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Authorized Official
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Title or Position | CEO
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Name | MICKEY FOSTER
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Credential |
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Telephone | 910-715-4473
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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 | H0100
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License Number State | NC
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