Individual
DR. JOHN E FIDLER JR.
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2400 WAYNE MEMORIAL DR, SUITE K, GOLDSBORO, NC 27534-1789
(919) 736-2082
(919) 734-0893
Mailing address
2400 WAYNE MEMORIAL DR, SUITE K, GOLDSBORO, NC 27534-1789
(919) 736-2082
(919) 734-0893
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
7575
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0160988
UNITED CONCORDIA
NC
05
—
89902J5
—
NC
01
—
902J5
BCBS OF NC
NC
Enumeration date
05/12/2006
Last updated
07/08/2007
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