Individual
DR. MEREDITH GENTRY LASATER BYRD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS, MPH
Contact information
Practice address
2800 WAKEFIELD PINES DR STE 110, RALEIGH, NC 27614-8597
(919) 488-0170
Mailing address
2800 WAKEFIELD PINES DR STE 110, RALEIGH, NC 27614-8597
(919) 488-0170
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
10107
NC
1223P0221X
Pediatric Dentistry
Primary
10107
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1205213295
—
NC
Enumeration date
04/29/2015
Last updated
10/23/2018
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