Individual
KAILA BROOKE CHAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
210 S WALNUT ST, FAIRMONT, NC 28340-1956
(910) 668-6534
(910) 668-6535
Mailing address
60 COMMERCE PLAZA CIR, PEMBROKE, NC 28372-7386
(910) 521-2900
(910) 775-9165
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
13736
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/03/2024
Last updated
06/10/2025
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