| Southern Village Dental | |
|
8838 Us 70 Hwy W Suite 100 Clayton NC 27520-4822 | |
| (919) 550-8171 | |
| Not Available |
| Full Name | Southern Village Dental |
|---|---|
| Speciality | Dentist |
| Location | 8838 Us 70 Hwy W, Clayton, North Carolina |
| Authorized Official Name and Position | Jason Robert Harris (DENTIST/OWNER) |
| Authorized Official Contact | 2522132545 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Village Dental 8838 Us 70 Hwy W Suite 100 Clayton NC 27520-4822 Ph: (919) 550-8171 | Southern Village Dental 8838 Us 70 Hwy W Suite 100 Clayton NC 27520-4822 Ph: (919) 550-8171 |
| NPI Number | 1699228486 |
|---|---|
| Provider Enumeration Date | 07/27/2016 |
| Last Update Date | 07/27/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699228486 | NPI | - | NPPES |
| 9744 | Other | NC | NC DENTAL LICENSE NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 9744 (North Carolina) | Primary |
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