# JAMES D DOUGLASS DDS PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306902416
- **Authorized official:** DR. JAMES DAVIS DOUGLASS JR. DDS (OWNER)
- **Authorized official phone:** (910) 323-8254

## Contact information

- **Practice address:** 101 WALL ST, FAYETTEVILLE, NC 28301-4761
- **Practice address phone:** (910) 323-8254
- **Practice address fax:** (910) 323-2532
- **Mailing address:** PO BOX 1449, FAYETTEVILLE, NC 28302-1449
- **Mailing address phone:** (910) 323-8254
- **Mailing address fax:** (910) 323-2532

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 3344 | NC | Yes |

## Other

- **Enumeration date:** 01/01/2007
- **Last updated:** 09/09/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 5950576 | — | NC |
| 01 | — | 809135 | UNITED CONCORDIA | NC |
| 01 | — | 92191 | BLUE CROSS BLUE SHIELD | NC |