Organization
A DARREN SHOLAR, DDS,PA
Active
Other names
Southland Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AXON DARREN SHOLAR DDS (PRESIDENT/OWNDER)
(910) 285-7800
Entity
Organization
Contact information
Practice address
522 S NORWOOD ST, WALLACE, NC 28466-1620
(910) 285-7800
(910) 285-6097
Mailing address
522 S NORWOOD ST, WALLACE, NC 28466-1620
(910) 285-7800
(910) 285-6097
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6268
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1680308
UNITED CONCORDIA
NC
01
—
385397
TRIGON
NC
05
—
8997800
—
NC
01
—
97800
BCBS
NC
Enumeration date
09/22/2008
Last updated
06/11/2020
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