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Organization
MICHAEL L. MOCK, DDS PA
Active
Organization
MICHAEL L. MOCK, DDS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL L. MOCK DDS, PA (PRESIDENT)
(704) 436-9397
Entity
Organization
Contact information
Practice address
1476 S MAIN ST., MT. PLEASANT, NC 28124-0847
(704) 436-9397
(704) 436-2203
Mailing address
PO BOX 846, 1476 SOUTH MAIN ST., MT. PLEASANT, NC 28124-0847
(704) 436-9397
(704) 436-2203
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4518
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4518
NC DENTAL LISCENSE
NC
05
—
8996027
—
NC
01
—
96027
BLUE CROSS AND BLUE SHIEL
NC
Enumeration date
12/11/2006
Last updated
08/22/2020
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