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General NPI Number Information
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NPI Number | 1598093205
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Entity Type | Organization
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Legal Business Name | DR. PETER G. LIM, D.D.S., P.L.L.C.
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Dates
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Enumeration Date | 11/19/2009
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Last Update Date | 11/19/2009
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Provider Practice Location Address
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Address Line | 4050 WAKE FOREST RD
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City | RALEIGH
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State | NC
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Zip | 29609-6860
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Country | US
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Telephone | 919-954-2273
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Fax | 919-521-5499
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Provider Business Mailing Address
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Address Line | 4050 WAKE FOREST RD P.O. BOX 18008
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City | RALEIGH
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State | NC
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Zip | 27619-8008
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Country | US
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Telephone | 919-954-2273
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Fax | 919-521-5499
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Authorized Official
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Title or Position | GENERAL DENTIST
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Name | DR. PETER GENE LIM
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Credential | D.D.S.
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Telephone | 919-954-2273
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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 | NC-8116
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License Number State | NC
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