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General NPI Number Information
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NPI Number | 1710692918
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Entity Type | Organization
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Legal Business Name | DRS. ABDELBAKY, BOES, CAMERON & ASSOCIATES OF FAYETTEVILLE PLLC
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Dates
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Enumeration Date | 01/23/2023
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Last Update Date | 01/25/2023
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Provider Practice Location Address
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Address Line | 2350 BENTRIDGE LN
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City | FAYETTEVILLE
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State | NC
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Zip | 28304-0590
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Country | US
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Telephone | 919-977-0627
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Fax |
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Provider Business Mailing Address
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Address Line | 2350 BENTRIDGE LN
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City | FAYETTEVILLE
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State | NC
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Zip | 28304-0590
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Country | US
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Telephone | 248-550-5440
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING SPECILIAST
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Name | AMENA HOLLEY
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Credential |
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Telephone | 248-550-5440
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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