| Martin Tyrrell Washington District Dental Clinic | |
|
198 Nc Highway 45 N Plymouth NC 27962-9232 | |
| (252) 793-3023 | |
| (252) 791-3159 |
| Full Name | Martin Tyrrell Washington District Dental Clinic |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 198 Nc Highway 45 N, Plymouth, North Carolina |
| Authorized Official Name and Position | Ronda B Phelps (ADMINISTRATIVE ASSISTANT II) |
| Authorized Official Contact | 2527933023 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Martin Tyrrell Washington District Dental Clinic 198 Nc Highway 45 N Plymouth NC 27962-9232 Ph: (252) 793-3023 | Martin Tyrrell Washington District Dental Clinic 198 Nc Highway 45 N Plymouth NC 27962-9232 Ph: (252) 793-3023 |
| NPI Number | 1558345983 |
|---|---|
| Provider Enumeration Date | 11/30/2005 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558345983 | NPI | - | NPPES |
| 3404410 | Medicaid | NC | |
| 07059 | Other | NC | BLUE CROSS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (North Carolina) | Primary |