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NPI Code Detail

MEDICARE: DR. CYNTHIA NICHOLS ELDERKIN D.D.S.

MEDICARE:  DR. CYNTHIA NICHOLS ELDERKIN  D.D.S.
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
1122300000XDentist5662NC

General Provider Information

NPI Number : 1205955887
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CYNTHIA NICHOLS ELDERKIN D.D.S.
Provider Business Mailing Address
First Line : 8015 CREEDMOOR RD
Second Line : SUITE 202
City : RALEIGH
State : NC
Zip : 27613-4397
Country : US
Telephone Number : 919-847-8747
Fax Number : 919-847-8747
Provider Business Practice Location Address
First Line : 8015 CREEDMOOR RD
Second Line : SUITE 202
City : RALEIGH
State : NC
Zip : 27613-4397
Country : US
Telephone Number : 919-847-8747
Fax Number : 919-847-8747
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2007
Last Update Date : 07/08/2007

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