Individual
DR. DOUGLAS KENNETH MACLEOD
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
6900 SIX FORKS RD, STE 104, RALEIGH, NC 27615-6427
(919) 848-8444
(919) 848-8445
Mailing address
6900 SIX FORKS RD, STE 104, RALEIGH, NC 27615-6427
(919) 848-8444
(919) 848-8445
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5363
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8995443
—
NC
01
—
95443
BLUE CROSS ID
NC
Enumeration date
06/16/2005
Last updated
07/08/2007
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