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General NPI Number Information
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NPI Number | 1689048738
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Entity Type | Individual
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Provider Name | JAMES BARRETT MACOMSON DDS, MSO
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Gender | Male
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Dates
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Enumeration Date | 11/30/2015
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Last Update Date | 11/30/2015
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Provider Practice Location Address
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Address Line | 1601 E GARRISON BLVD SUITE B
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City | GASTONIA
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State | NC
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Zip | 28054-5139
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Country | US
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Telephone | 704-867-3667
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Fax | 704-867-3415
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Provider Business Mailing Address
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Address Line | 1601 E GARRISON BLVD SUITE B
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City | GASTONIA
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State | NC
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Zip | 28054-5139
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Country | US
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Telephone | 704-867-3667
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Fax | 704-867-3415
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 3582
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License Number State | NC
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