Individual
IVY PAULINE BRISBIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS, MS
Contact information
Practice address
1107 S FIFTH ST STE 100, MEBANE, NC 27302-9596
(919) 568-0103
Mailing address
414 MORGAN CREEK RD, CHAPEL HILL, NC 27517-4934
(980) 234-0374
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
10451
NC
Other
Enumeration date
05/10/2016
Last updated
08/13/2019
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