Individual
DR. SAMUEL RAY CROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
401 DOCTOR'S CIRCLE, ELIZABETHTOWN, NC 28337
(910) 862-2892
Mailing address
401 DOCTOR'S CIRCLE, ELIZABETHTOWN, NC 28337
(910) 862-2892
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4625
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8991904
—
NC
01
—
91904
BCBS
NC
01
—
U37843
UPIN
NC
Enumeration date
01/24/2008
Last updated
01/24/2008
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