Organization
ROYSTER, SMIH, LANNING & BUNDY DDS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUZY MANTEL RDH (OFFICE ADMINISTRATOR)
(336) 476-6129
Entity
Organization
Contact information
Practice address
179 W SALISBURY ST, DENTON, NC 27239-6926
(336) 859-4435
(336) 859-5682
Mailing address
PO BOX 428, DENTON, NC 27239-0428
(336) 859-4435
(336) 859-5682
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
015WE
MEDICAID #
NC
Enumeration date
03/06/2007
Last updated
08/22/2020
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