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General NPI Number Information
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NPI Number | 1477024529
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Entity Type | Organization
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Legal Business Name | STEVEN J. BUMGARNER, D.D.S. & JAMES P. MARTIN, D.M.D., M.S., P.A.
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Dates
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Enumeration Date | 12/16/2018
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Last Update Date | 09/06/2019
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Provider Practice Location Address
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Address Line | 1268 S MAIN ST
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City | WAKE FOREST
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State | NC
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Zip | 27587-4997
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Country | US
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Telephone | 919-556-7820
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Fax |
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Provider Business Mailing Address
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Address Line | 1268 S MAIN ST
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City | WAKE FOREST
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State | NC
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Zip | 27587-4997
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Country | US
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Telephone | 919-556-7820
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Fax |
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Authorized Official
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Title or Position | ORTHODONTIST
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Name | JAMES PATRICK MARTIN
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Credential | D.M.D., M.S.
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Telephone | 919-495-8591
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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