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General NPI Number Information
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NPI Number | 1790212462
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Entity Type | Organization
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Legal Business Name | EAST CAROLINA UNIVERSITY
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Dates
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Enumeration Date | 05/12/2017
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Last Update Date | 07/26/2024
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Provider Practice Location Address
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Address Line | 1851 MACGREGOR DOWNS RD
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City | GREENVILLE
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State | NC
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Zip | 27834-5925
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Country | US
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Telephone | 252-737-7011
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Fax | 252-737-7846
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Provider Business Mailing Address
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Address Line | 1851 MACGREGOR DOWNS RD
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City | GREENVILLE
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State | NC
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Zip | 27834
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Country | US
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Telephone | 252-737-7122
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Fax | 252-737-0221
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Authorized Official
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Title or Position | DEAN, SCHOOL OF DENTAL MEDIICNE
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Name | DR. DEXTER GREGORY CHADWICK
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Credential | DDS, MS
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Telephone | 252-737-7000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0106X
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Taxonomy Name | Oral and Maxillofacial Pathology Dentistry
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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 | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 1223X0008X
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Taxonomy Name | Oral and Maxillofacial Radiology Dentistry
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 125Q00000X
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Taxonomy Name | Oral Medicine Dentistry
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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