Organization
N. KEPHART DDS PLLC
Active
Other names
Davie Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NICKOLAS ANDREW KEPHART DDS (OWNER)
(336) 760-9840
Entity
Organization
Contact information
Practice address
330 HOSPITAL ST, MOCKSVILLE, NC 27028-2061
(336) 760-9840
Mailing address
330 HOSPITAL ST, MOCKSVILLE, NC 27028-2061
(336) 760-9840
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1154559318
NPI
VA
01
—
1427494350
NPI
NC
Enumeration date
08/16/2019
Last updated
08/16/2019
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