Individual
JEREMIAH JAMES FAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1915 W PARK DR STE 104, NORTH WILKESBORO, NC 28659-3777
(336) 903-9399
(336) 903-0464
Mailing address
1915 W PARK DR STE 104, NORTH WILKESBORO, NC 28659-3777
(336) 903-9399
(336) 903-0464
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10706
NC
Other
Enumeration date
06/12/2017
Last updated
07/21/2022
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