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General NPI Number Information
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NPI Number | 1639390826
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Entity Type | Organization
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Legal Business Name | DR. THOMAS WOODARD P.A.
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Dates
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Enumeration Date | 05/02/2007
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Last Update Date | 07/23/2008
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Provider Practice Location Address
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Address Line | 8220 UNIVERSITY EXEC PARK DR SUITE 150
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City | CHARLOTTE
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State | NC
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Zip | 28262-3380
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Country | US
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Telephone | 704-548-1653
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Fax | 704-548-8761
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Provider Business Mailing Address
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Address Line | 8220 UNIVERSITY EXEC PARK DR SUITE 150
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City | CHARLOTTE
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State | NC
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Zip | 28262-3380
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Country | US
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Telephone | 704-548-1653
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Fax | 704-548-8761
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Authorized Official
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Title or Position | ORTHODONIST
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Name | DR. THOMAS WOODARD
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Credential | DDS
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Telephone | 704-548-1653
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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 | 4421
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License Number State | NC
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