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General NPI Number Information
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NPI Number | 1467634980
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Entity Type | Organization
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Legal Business Name | DR. N. CARROLL MULLINS, D.D.S., P.C.
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Dates
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Enumeration Date | 11/27/2007
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Last Update Date | 11/27/2007
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Provider Practice Location Address
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Address Line | 728 COMMONWEALTH DR
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City | NORTON
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State | VA
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Zip | 24273-4051
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Country | US
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Telephone | 276-679-7171
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Fax | 276-679-7222
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Provider Business Mailing Address
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Address Line | 728 COMMONWEALTH DR
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City | NORTON
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State | VA
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Zip | 24273-4051
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Country | US
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Telephone | 276-679-7171
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Fax | 276-679-7222
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Authorized Official
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Title or Position | OWNER
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Name | DR. NEWTON CARROLL MULLINS
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Credential | DDS
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Telephone | 276-679-7171
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 0401004680
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License Number State | VA
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