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NPI Code Detail

MEDICARE: JOHN C. WOODALL, D.D.S., P.A.

MEDICARE: JOHN C. WOODALL, D.D.S., P.A.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry4457NC

General Provider Information

NPI Number : 1184820078
Entity Type Code : Organization
Provider Name (Legal Business Name) : JOHN C. WOODALL, D.D.S., P.A.
Provider Business Mailing Address
First Line : 2020 FAIRVIEW RD
Second Line :
City : RALEIGH
State : NC
Zip : 27608-2316
Country : US
Telephone Number : 919-821-2595
Fax Number :
Provider Business Practice Location Address
First Line : 2020 FAIRVIEW RD
Second Line :
City : RALEIGH
State : NC
Zip : 27608-2316
Country : US
Telephone Number : 919-821-2595
Fax Number :
Authorized Official
Title or Position : P.A.
Name : DR. JOHN C. WOODALL
Credential : D.D.S.
Telephone Number : 919-821-2595
Provider Enumeration Date : 06/26/2007
Last Update Date : 09/07/2023

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