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General NPI Number Information
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NPI Number | 1598833451
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Entity Type | Organization
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Legal Business Name | KIM PRYZGODA DDS PA
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Dates
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Enumeration Date | 11/30/2006
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Last Update Date | 02/28/2025
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Provider Practice Location Address
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Address Line | 653 HAY STREET
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City | FAYETTEVILLE
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State | NC
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Zip | 28301
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Country | US
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Telephone | 910-826-8900
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Fax | 910-826-2244
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Provider Business Mailing Address
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Address Line | 653 HAY STREET
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City | FAYETTEVILLE
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State | NC
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Zip | 28301
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Country | US
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Telephone | 910-826-8900
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Fax | 910-826-2244
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Authorized Official
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Title or Position | OWNER DENTIST
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Name | DR. KIMBERLY WILSON PRYZGODA
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Credential | DDS
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Telephone | 910-826-8900
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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 | 6373
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License Number State | NC
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