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General NPI Number Information
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NPI Number | 1457722746
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Entity Type | Organization
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Legal Business Name | DRS. NEGASH ANDEMICHAEL AND ASSOCATES, P.A.
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Dates
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Enumeration Date | 10/12/2015
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Last Update Date | 10/12/2015
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Provider Practice Location Address
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Address Line | 205 W FRONT ST
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City | LILLINGTON
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State | NC
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Zip | 27546-5821
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Country | US
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Telephone | 910-984-1556
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Fax | 910-984-1557
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Provider Business Mailing Address
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Address Line | 205 W FRONT ST
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City | LILLINGTON
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State | NC
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Zip | 27546-5821
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Country | US
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Telephone | 910-984-1556
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Fax | 910-984-1557
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MERON NEGASH ANDEMICHAEL
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Credential | DDS
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Telephone | 910-984-1556
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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 | 9660
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License Number State | NC
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