| Dental Derby | |
|
10564 S Us Highway 15 501 Ste E Southern Pines NC 28387-5166 | |
| (214) 830-9332 | |
| Not Available |
| Full Name | Dental Derby |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 10564 S Us Highway 15 501 Ste E, Southern Pines, North Carolina |
| Authorized Official Name and Position | Jose Alberto Cangas (OWNER) |
| Authorized Official Contact | 2148309332 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dental Derby 10564 S Us Highway 15 501 Ste E Southern Pines NC 28387-5166 Ph: (214) 830-9332 | Dental Derby 10564 S Us Highway 15 501 Ste E Southern Pines NC 28387-5166 Ph: (214) 830-9332 |
| NPI Number | 1417364605 |
|---|---|
| Provider Enumeration Date | 07/19/2014 |
| Last Update Date | 07/19/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417364605 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 9374 (North Carolina) | Primary |
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