# A DARREN SHOLAR, DDS,PA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Southland Dental Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053561555
- **Authorized official:** DR. AXON DARREN SHOLAR DDS (PRESIDENT/OWNDER)
- **Authorized official phone:** (910) 285-7800

## Contact information

- **Practice address:** 522 S NORWOOD ST, WALLACE, NC 28466-1620
- **Practice address phone:** (910) 285-7800
- **Practice address fax:** (910) 285-6097
- **Mailing address:** 522 S NORWOOD ST, WALLACE, NC 28466-1620
- **Mailing address phone:** (910) 285-7800
- **Mailing address fax:** (910) 285-6097

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 6268 | NC | Yes |

## Other

- **Enumeration date:** 09/22/2008
- **Last updated:** 06/11/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1680308 | UNITED CONCORDIA | NC |
| 01 | — | 385397 | TRIGON | NC |
| 05 | — | 8997800 | — | NC |
| 01 | — | 97800 | BCBS | NC |