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General NPI Number Information
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NPI Number | 1871953554
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Entity Type | Organization
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Legal Business Name | JOHN M. ROMULUS DDS PA
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Dates
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Enumeration Date | 02/24/2016
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Last Update Date | 02/24/2016
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Provider Practice Location Address
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Address Line | 3301 HENDERSON DR
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City | JACKSONVILLE
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State | NC
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Zip | 28546-5231
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Country | US
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Telephone | 910-938-4333
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Fax | 910-938-2889
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Provider Business Mailing Address
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Address Line | 3301 HENDERSON DR
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City | JACKSONVILLE
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State | NC
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Zip | 28546-5231
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Country | US
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Telephone | 910-938-4333
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Fax | 910-938-2889
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | DEBORAH LEE
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Credential |
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Telephone | 910-938-4333
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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 | 5368
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License Number State | NC
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