Organization
MACON, COLLIE, PRETZER, KORNSTEIN AND HICKS DDS
Active
Other names
Wake Orthodontics & Pediatric Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
LINDA TARANTINO (PRACTICE MANAGER)
(919) 719-1780
Entity
Organization
Contact information
Practice address
7401 CREEDMOOR RD, RALEIGH, NC 27613-1640
(919) 848-3588
(919) 846-3550
Mailing address
7401 CREEDMOOR RD, RALEIGH, NC 27613-1640
(919) 848-3588
(919) 846-3550
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
2934
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12624
KATHRYN E. DUNDERVILL DDS
NC
01
—
6367
ROBERT A. MORAN JR. DDS
NC
01
—
7712
DAVID J. KORNSTEIN, DDS
NC
01
—
8578
TRAVIS M. HICKS, DDS
NC
01
—
90106
STEPHEN C. PRETZER - BCBS
NC
Enumeration date
05/04/2006
Last updated
10/05/2023
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