Individual
DR. SANTA MARIA MCKIBBINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S
Contact information
Practice address
1413 W NC HIGHWAY 54, DURHAM, NC 27707-5507
(919) 493-6860
(919) 493-6869
Mailing address
1413 W NC HIGHWAY 54, DURHAM, NC 27707-5507
(919) 493-6860
(919) 493-6869
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6935
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1633202
UNITED CONCORDIA
—
05
—
799002R
—
NC
01
—
9002R
HEALTHCHOICE
NC
Enumeration date
01/08/2007
Last updated
07/31/2012
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