1548572498 NPI number — GUNTER AND GRAHAM, D.D.S., P.A.

Table of content: (NPI 1548572498)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548572498 NPI number — GUNTER AND GRAHAM, D.D.S., P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GUNTER AND GRAHAM, D.D.S., P.A.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1548572498
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/08/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
221 13TH AVENUE PLACE NORTHWEST,
Provider Second Line Business Mailing Address:
SUITE 102
Provider Business Mailing Address City Name:
HICKORY
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28601
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-328-5581
Provider Business Mailing Address Fax Number:
828-322-1745

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
221 13TH AVENUE PLACE NORTHWEST,
Provider Second Line Business Practice Location Address:
SUITE 102
Provider Business Practice Location Address City Name:
HICKORY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28601
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-328-5581
Provider Business Practice Location Address Fax Number:
828-322-1745
Provider Enumeration Date:
07/08/2010

Additional Information

Authorized Official

Authorized Official Last Name:
HULL
Authorized Official First Name:
DEBORAH
Authorized Official Middle Name:
D.
Authorized Official Title or Position:
FINANCIAL MNG.
Authorized Official Telephone Number:
828-328-5581

Provider Taxonomy Codes

  • Taxonomy code: 122300000X , with the licence number:  3926 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 122300000X , with the licence number: 8371 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 5910909 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com