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NPI Code Detail

MEDICARE: DR. VIRGINIA ALLISON PRATT DMD

MEDICARE:  DR. VIRGINIA ALLISON PRATT  DMD
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
1122300000XDentist11485NC

General Provider Information

NPI Number : 1265084305
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. VIRGINIA ALLISON PRATT DMD
Provider Business Mailing Address
First Line : 851 SCOTCH HALL WAY APT 308
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28303-4897
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 600 COUNTRY CLUB RD
Second Line :
City : LUMBERTON
State : NC
Zip : 28360-0428
Country : US
Telephone Number : 910-737-6457
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/09/2019
Last Update Date : 07/09/2019

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Directions to “ DR. VIRGINIA ALLISON PRATT DMD” Practice Location

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