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Individual

THEODORE GABRIEL MUCHITENI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.M.D.

Contact information

Practice address
2300 HEMBY LN, GREENVILLE, NC 27834-3775
(252) 830-0201
(252) 830-2052
Mailing address
2300 HEMBY LN, GREENVILLE, NC 27834-3775
(252) 830-0201
(252) 830-2052

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
5566
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
208734
TRIGON BCBS
01
523612
UNITED CONCORDIA
01
69278
BLUE CROSS BLUE SHIELD OF
NC
05
6996278
NC
Enumeration date
08/12/2005
Last updated
06/13/2008
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