Individual
FELIPE JUNGBLUT MOHR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2050 SKIBO RD STE 104, FAYETTEVILLE, NC 28314-3161
(910) 605-4106
Mailing address
1105 BARLEY STONE WAY, RALEIGH, NC 27603-5194
(636) 448-4658
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12892
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/01/2022
Last updated
07/13/2022
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