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NPI Code Detail

MEDICARE: DR ROMAN AND ASSOCIATES

MEDICARE: DR ROMAN AND ASSOCIATES
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
1261QD0000XDental Clinic/Center8397

General Provider Information

NPI Number : 1407294200
Entity Type Code : Organization
Provider Name (Legal Business Name) : DR ROMAN AND ASSOCIATES
Provider Business Mailing Address
First Line : PO BOX 500
Second Line :
City : SPRING LAKE
State : NC
Zip : 28390-0500
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 620 LILLINGTON HWY
Second Line :
City : SPRING LAKE
State : NC
Zip : 28390-2119
Country : US
Telephone Number : 919-225-0613
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. ERIC J ROMAN
Credential : DDS
Telephone Number : 919-225-0613
Provider Enumeration Date : 06/13/2013
Last Update Date : 06/13/2013

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