ECU PEDIATRIC DENTAL CLINIC NPI 1659536522

NPI Information

ECU PEDIATRIC DENTAL CLINIC is a pediatric dentistry dentist in Greenville, NC. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. ECU PEDIATRIC DENTAL CLINIC NPI is 1659536522. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2150 HERBERT CT
GREENVILLE, NC
ZIP 27834-736
Phone: (252) 744-3258
Fax: (252) 744-3194

The provider's authorized official is Nicholas Benson .
The authorized official title is Vice Dean and has the following contact phone number (252) 744-7400.

The CLIA number assigned to this NPI record is 34D1032539 - ancillary testing site in health care center with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 7/21/2008 and was last updated on 1/16/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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