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General NPI Number Information
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NPI Number | 1578747507
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Entity Type | Organization
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Legal Business Name | BRYAN R NEUWIRTH DDS MD PC
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Dates
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Enumeration Date | 12/27/2007
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Last Update Date | 10/20/2010
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Provider Practice Location Address
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Address Line | 261 18TH ST CR SE
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City | HICKORY
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State | NC
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Zip | 28602-1362
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Country | US
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Telephone | 828-327-7867
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Fax | 828-327-6299
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Provider Business Mailing Address
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Address Line | 261 18TH ST CR SE
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City | HICKORY
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State | NC
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Zip | 28602-1362
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Country | US
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Telephone | 828-327-7867
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Fax | 828-327-6299
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. REBECCA B MCKENZIE
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Credential |
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Telephone | 828-327-7867
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 36121
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License Number State | NC
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