Organization
SAMUEL RAY CROSS DDS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL RAY CROSS DDS (PRESIDENT)
(910) 862-2892
Entity
Organization
Contact information
Practice address
401 DOCTORS CIRCLE, ELIZABETHTOWN, NC 28337
(910) 862-2892
(910) 862-6345
Mailing address
PO BOX 1736, 401 DOCTORS CIRCLE, ELIZABETHTOWN, NC 28337
(910) 862-2892
(910) 862-6345
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4625
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8991904
—
NC
01
—
91904
BCBS
NC
Enumeration date
08/19/2006
Last updated
04/26/2013
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