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Organization
TRACY J. WATERS, DDS., PA
Active
Organization
TRACY J. WATERS, DDS., PA
Active
Other names
Carolina Smiles Dental Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TRACY J. WATERS DDS, PA (PRESIDENT)
(919) 620-6700
Entity
Organization
Contact information
Practice address
4210 N ROXBORO ST, SUITE 100, DURHAM, NC 27704-1826
(919) 620-6700
(919) 620-7360
Mailing address
4210 N ROXBORO ST, SUITE 100, DURHAM, NC 27704-1826
(919) 620-6700
(919) 620-7360
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7337
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89016JF
—
NC
Enumeration date
11/08/2006
Last updated
06/12/2008
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