MEDICARE: DR. JAMES D. BOHN III D.M.D.

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	8872	NC

General Provider Information

NPI Number	:	1881600104
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES D. BOHN III D.M.D.

Provider Business Mailing Address
First Line	:	3100 NC HIGHWAY 55
Second Line	:	SUITE 201
City	:	CARY
State	:	NC
Zip	:	27519-8426
Country	:	US
Telephone Number	:	919-363-3133
Fax Number	:	919-363-3134

Provider Business Practice Location Address
First Line	:	3100 NC HIGHWAY 55
Second Line	:	SUITE 201
City	:	CARY
State	:	NC
Zip	:	27519-8426
Country	:	US
Telephone Number	:	919-363-3133
Fax Number	:	919-363-3134

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

Provider Enumeration Date	:	07/31/2006
Last Update Date	:	10/04/2010

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