WILMINGTON AESTHETIC FACIAL PLASTIC AND RECONSTRUCTIVE CENTER LLC NPI 1316202948

NPI Information

WILMINGTON AESTHETIC FACIAL PLASTIC AND RECONSTRUCTIVE CENTER, LLC is a facial plastic surgery otolaryngology in Wilmington, NC. The provider is an otolaryngologist who specializes in facial plastic surgery. WILMINGTON AESTHETIC FACIAL PLASTIC AND RECONSTRUCTIVE CENTER, LLC NPI is 1316202948. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1604 PHYSICIANS DR
103
WILMINGTON, NC
ZIP 28401-362
Phone: (910) 762-1070
Fax: (910) 762-1083

The provider's authorized official is Deidra A Blanks .
The authorized official title is Owner and has the following contact phone number (910) 762-1070.

The enumeration date for this NPI number is 7/10/2012 and was last updated on 7/26/2012.

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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