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Organization
HUSHANG GHODRAT DDS, PA
Active
Organization
HUSHANG GHODRAT DDS, PA
Active
Other names
Butner Creedmoor Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
JAMIE M. BRUMMITT (OFFICE MANGAER)
(919) 528-9500
Entity
Organization
Contact information
Practice address
2552 CAPITOL DR, SUITE 101, CREEDMOOR, NC 27522-9451
(919) 528-9500
(919) 528-9556
Mailing address
2552 CAPITOL DR, SUITE 101, CREEDMOOR, NC 27522-9451
(919) 528-9500
(919) 528-9556
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6984
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5900569
—
NC
Enumeration date
05/25/2007
Last updated
06/17/2008
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