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General NPI Number Information
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NPI Number | 1861586919
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Entity Type | Organization
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Legal Business Name | S. JASON TROUTMAN D.D.S., PLLC
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 200 MEBANE OAKS RD
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City | MEBANE
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State | NC
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Zip | 27302-9643
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Country | US
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Telephone | 919-563-5939
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Fax | 919-563-6676
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Provider Business Mailing Address
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Address Line | 200 MEBANE OAKS RD
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City | MEBANE
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State | NC
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Zip | 27302-9643
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Country | US
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Telephone | 919-563-5939
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Fax | 919-563-6676
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | DR. S JASON TROUTMAN
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Credential | D.D.S.
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Telephone | 919-563-5939
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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 | 8187
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License Number State | NC
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