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General NPI Number Information
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NPI Number | 1922293521
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Entity Type | Organization
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Legal Business Name | DUSTIN DURDEN DDS, KATINA PITTMAN DDS,PA, /MCCRIMMON FAMILY DENTISTRY
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Dates
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Enumeration Date | 09/07/2007
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Last Update Date | 06/18/2008
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Provider Practice Location Address
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Address Line | 6402 MCCRIMMON PARKWAY SUITE #400
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City | MORRISVILLE
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State | NC
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Zip | 27560-8136
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Country | US
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Telephone | 919-380-3060
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Fax | 919-380-4494
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Provider Business Mailing Address
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Address Line | 6402 MCCRIMMON PARKWAY SUITE #400
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City | MORRISVILLE
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State | NC
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Zip | 27560-8136
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Country | US
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Telephone | 919-380-3060
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Fax | 919-380-4494
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. ROBYN SUZANNE MANCHESTER
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Credential |
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Telephone | 919-380-3060
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 7649
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 7602
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License Number State | NC
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