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General NPI Number Information
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NPI Number | 1558809210
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Entity Type | Organization
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Legal Business Name | ANDREW R. PERNELL, DDS, PLLC
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Dates
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Enumeration Date | 02/02/2017
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Last Update Date | 02/02/2017
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Provider Practice Location Address
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Address Line | 12823 HERITAGE VISTA DR
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City | HUNTERSVILLE
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State | NC
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Zip | 28078-6058
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Country | US
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Telephone | 828-310-7860
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Fax |
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Provider Business Mailing Address
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Address Line | 275 N HIGHWAY 16 SUITE 101
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City | DENVER
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State | NC
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Zip | 28037-3000
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Country | US
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Telephone | 980-247-0040
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ANDREW R. PERNELL
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Credential | DDS
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Telephone | 980-247-0040
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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 |
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License Number State |
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