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General NPI Number Information
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NPI Number | 1396243549
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Entity Type | Organization
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Legal Business Name | KRISTEN L. LANGWORTHY, DDS, PLLC
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Dates
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Enumeration Date | 01/23/2018
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Last Update Date | 07/18/2023
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Provider Practice Location Address
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Address Line | 947 S JUDD PARKWAY SE
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City | FUQUAY VARINA
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State | NC
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Zip | 27526
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Country | US
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Telephone | 919-552-5113
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Fax | 919-552-2193
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Provider Business Mailing Address
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Address Line | 947 S JUDD PARKWAY SE
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City | FUQUAY VARINA
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State | NC
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Zip | 27526
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Country | US
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Telephone | 919-552-5113
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Fax | 919-552-2193
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | DR. KRISTEN LABIANCA LANGWORTHY
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Credential | DDS
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Telephone | 919-552-5113
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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 | 9748
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License Number State | NC
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