MEDICARE: BOBBEE VANNASANE DDS

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
1	1223G0001X	General Practice Dentistry	12774	NC

General Provider Information

NPI Number	:	1598495699
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BOBBEE VANNASANE DDS

Provider Business Mailing Address
First Line	:	1628 MEMORIAL DR STE B
Second Line	:
City	:	BURLINGTON
State	:	NC
Zip	:	27215-3596
Country	:	US
Telephone Number	:	336-226-5485
Fax Number	:

Provider Business Practice Location Address
First Line	:	1628 MEMORIAL DR STE B
Second Line	:
City	:	BURLINGTON
State	:	NC
Zip	:	27215-3596
Country	:	US
Telephone Number	:	336-226-5485
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2022
Last Update Date	:	06/13/2022

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Directions to “ BOBBEE VANNASANE DDS” Practice Location

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