# ANTHONY R. IMMEDIATA, D.M.D, P.A.

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

## Provider details

- **NPI number:** 1861643678
- **Authorized official:** MS. BARBARA SED (OFFICE MANAGER)
- **Authorized official phone:** (919) 846-5500

## Contact information

- **Practice address:** 7101 CREEDMOOR RD, SUITE 109, RALEIGH, NC 27613-1682
- **Practice address phone:** (919) 846-5500
- **Practice address fax:** (919) 846-7964
- **Mailing address:** 7101 CREEDMOOR RD, SUITE 109, RALEIGH, NC 27613-1682
- **Mailing address phone:** (919) 846-5500
- **Mailing address fax:** (919) 846-7964

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 5022 | NC | Yes |

## Other

- **Enumeration date:** 10/10/2008
- **Last updated:** 12/03/2008