Organization
J. RANDALL LATTA, DDS & ASSOCIATES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. J. RANDALL LATTA DDS (PRESIDENT)
(252) 305-1286
Entity
Organization
Contact information
Practice address
3179 SWEETEN CREEK RD, SUITE D, ASHEVILLE, NC 28803-2115
(252) 305-1286
Mailing address
PO BOX 1110, ASHEVILLE, NC 28802-1110
(252) 305-1286
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4081
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89-95125
—
NC
Enumeration date
02/18/2008
Last updated
02/18/2008
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