MEDICARE: DRS. PERRINE & WILEY, P.A.

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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	200001384207	NC

General Provider Information

NPI Number	:	1639253065
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DRS. PERRINE & WILEY, P.A.

Provider Business Mailing Address
First Line	:	2300 WAYNE MEMORIAL DR
Second Line	:	SUITE C
City	:	GOLDSBORO
State	:	NC
Zip	:	27534-1726
Country	:	US
Telephone Number	:	919-735-5999
Fax Number	:	919-735-5963

Provider Business Practice Location Address
First Line	:	2300 WAYNE MEMORIAL DR
Second Line	:	SUITE C
City	:	GOLDSBORO
State	:	NC
Zip	:	27534-1726
Country	:	US
Telephone Number	:	919-735-5999
Fax Number	:	919-735-5963

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. CYNTHIA S. WILEY
Credential	:	D.M.D., M.D.S.
Telephone Number	:	919-735-5999

Provider Enumeration Date	:	10/24/2006
Last Update Date	:	08/22/2020

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Directions to “DRS. PERRINE & WILEY, P.A. ” Practice Location

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