Organization
JAMES D DOUGLASS DDS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES DAVIS DOUGLASS JR. DDS (OWNER)
(910) 323-8254
Entity
Organization
Contact information
Practice address
101 WALL ST, FAYETTEVILLE, NC 28301-4761
(910) 323-8254
(910) 323-2532
Mailing address
PO BOX 1449, FAYETTEVILLE, NC 28302-1449
(910) 323-8254
(910) 323-2532
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3344
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5950576
—
NC
01
—
809135
UNITED CONCORDIA
NC
01
—
92191
BLUE CROSS BLUE SHIELD
NC
Enumeration date
01/01/2007
Last updated
09/09/2010
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