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General NPI Number Information
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NPI Number | 1760222558
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Entity Type | Individual
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Provider Name | LINDSEY TAYLOR RANALLO DMD
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Gender | Female
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Dates
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Enumeration Date | 05/29/2024
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Last Update Date | 04/15/2025
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Provider Practice Location Address
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Address Line | 5413 WATERGRASS DR
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City | WILMINGTON
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State | NC
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Zip | 28412-7803
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Country | US
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Telephone | 910-756-3065
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Fax |
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Provider Business Mailing Address
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Address Line | 5336 VOLUNTEER AVE UNIT 101
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City | WILMINGTON
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State | NC
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Zip | 28412-0422
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Country | US
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Telephone | 919-302-2124
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Fax |
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 13855
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License Number State | NC
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