| Dr Tracie Leigh Vestal, DDS | |
|
500 W Broad St, Elizabethtown, NC 28337-9411 | |
| (910) 862-4078 | |
| (910) 862-4078 |
| Full Name | Dr Tracie Leigh Vestal |
|---|---|
| Gender | Female |
| Speciality | Dentist - General Practice |
| Location | 500 W Broad St, Elizabethtown, North Carolina |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346304250 | NPI | - | NPPES |
| 871334 | Other | NC | UNITED CONCORDIA |
| 902-EC | Other | NC | BCBS ID# |
| 01-0570076 | Other | NC | FEDERAL TAX ID # |
| 7200 | Other | NC | STATE DENTAL LICENSE # |
| 89902EC | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 7200 (North Carolina) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Tracie Leigh Vestal, DDS 500 W Broad St, Elizabethtown, NC 28337-9411 Ph: (910) 862-4078 | Dr Tracie Leigh Vestal, DDS 500 W Broad St, Elizabethtown, NC 28337-9411 Ph: (910) 862-4078 |
Dr. Charles Davis Allen Jr., DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 508 Mckay St., Elizabethtown, NC 28337 Phone: 910-862-4334 Fax: 910-862-3813 | |
Dr. Samuel Ray Cross, Dentist Medicare: Medicare Enrolled Practice Location: 401 Doctor's Circle, Elizabethtown, NC 28337 Phone: 910-862-2892 | |
Dr. Clemuel Mansey Johnson, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 101 Dunham Street, Elizabethtown, NC 28337 Phone: 910-862-3943 Fax: 910-862-2363 |