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NPI Code Detail

MEDICARE: FRISCO DENTAL IMPLANT CENTER PLLC

MEDICARE: FRISCO DENTAL IMPLANT CENTER PLLC
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 Dentistry

General Provider Information

NPI Number : 1497566087
Entity Type Code : Organization
Provider Name (Legal Business Name) : FRISCO DENTAL IMPLANT CENTER PLLC
Provider Business Mailing Address
First Line : 1109 CROSS LINK RD # B-153
Second Line :
City : RALEIGH
State : NC
Zip : 27610-4842
Country : US
Telephone Number : 919-926-8428
Fax Number :
Provider Business Practice Location Address
First Line : 1 GLENWOOD AVE # 5
Second Line :
City : RALEIGH
State : NC
Zip : 27603-2578
Country : US
Telephone Number : 919-926-8428
Fax Number :
Authorized Official
Title or Position : OWNER
Name : ALECIA HARDY
Credential : DDS
Telephone Number : 919-926-8428
Provider Enumeration Date : 01/14/2025
Last Update Date : 03/03/2026

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Directions to “FRISCO DENTAL IMPLANT CENTER PLLC ” Practice Location

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