Organization
LARRY E.BAUCOM, D.D.S., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LARRY E. BAUCOM D.D.S. (OWNER)
(910) 295-1010
Entity
Organization
Contact information
Practice address
305 PAGE RD., SUITE 2, PINEHURST, NC 28374
(910) 295-1010
(910) 295-1367
Mailing address
PO BOX 789, PINEHURST, NC 28370-0789
(910) 295-1010
(910) 295-1367
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
3258
NC
Other
Enumeration date
03/27/2007
Last updated
08/22/2020
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