| Jeremiah C Davis, Dds, Mba, Pa | |
|
6402 Yadkin Rd Fayetteville NC 28303 | |
| (910) 864-4646 | |
| Not Available |
| Full Name | Jeremiah C Davis, Dds, Mba, Pa |
|---|---|
| Speciality | Clinic/Center |
| Location | 6402 Yadkin Rd, Fayetteville, North Carolina |
| Authorized Official Name and Position | Jeremiah C Davis (OWNER) |
| Authorized Official Contact | 9108644646 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jeremiah C Davis, Dds, Mba, Pa 7151 Okelly Chapel Rd # 318 Cary NC 27519-6849 Ph: (910) 864-4646 | Jeremiah C Davis, Dds, Mba, Pa 6402 Yadkin Rd Fayetteville NC 28303 Ph: (910) 864-4646 |
| NPI Number | 1811497761 |
|---|---|
| Provider Enumeration Date | 02/16/2018 |
| Last Update Date | 10/29/2020 |
| Medicare PECOS PAC ID | 6103243738 |
|---|---|
| Medicare Enrollment ID | O20200827003287 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811497761 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 9774 (North Carolina) | Primary |
| Provider Name | Jeremiah C. Davis |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1033522198 PECOS PAC ID: 1153748777 Enrollment ID: I20200827003045 |
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