Organization
MICHAEL L. MOCK, DDS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL L. MOCK DDS, PA (PRESIDENT)
(704) 436-9397
Entity
Organization
Contact information
Practice address
1476 S MAIN ST., MT. PLEASANT, NC 28124-0847
(704) 436-9397
(704) 436-2203
Mailing address
PO BOX 846, 1476 SOUTH MAIN ST., MT. PLEASANT, NC 28124-0847
(704) 436-9397
(704) 436-2203
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4518
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4518
NC DENTAL LISCENSE
NC
05
—
8996027
—
NC
01
—
96027
BLUE CROSS AND BLUE SHIEL
NC
Enumeration date
12/11/2006
Last updated
08/22/2020
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