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General NPI Number Information
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NPI Number | 1417397365
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Entity Type | Organization
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Legal Business Name | ALLISON C. EGGLESTON, DDS, PC
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Dates
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Enumeration Date | 06/25/2013
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Last Update Date | 06/25/2013
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Provider Practice Location Address
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Address Line | 6781 PARKER FARM DR SUITE 100
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City | WILMINGTON
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State | NC
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Zip | 28405-3160
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Country | US
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Telephone | 910-795-2511
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Fax | 910-679-4835
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Provider Business Mailing Address
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Address Line | 6781 PARKER FARM DR SUITE 100
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City | WILMINGTON
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State | NC
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Zip | 28405-3160
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Country | US
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Telephone | 910-795-2511
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Fax | 910-679-4835
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Authorized Official
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Title or Position | OWNER, PEDIATRIC DENTIST
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Name | DR. ALLISON CAVENAUGH EGGLESTON
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Credential | DDS, MS
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Telephone | 910-520-3319
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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 | 8836
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License Number State | NC
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