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Organization

LARRY DASHOW MD PC

Active
Other names
PENDER SURGICAL SERVICE
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LARRY J DASHOW MD (PRESIDENT)
(910) 259-8001
Entity
Organization

Contact information

Practice address
308 S BENNETT ST, BURGAW, NC 28425-5048
(910) 259-8001
(910) 259-8003
Mailing address
308 S BENNETT ST, BURGAW, NC 28425-5048
(910) 259-8001
(910) 259-8003

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
200300461
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
13350
BCBS
NC
05
8913350
NC
Enumeration date
10/31/2007
Last updated
08/04/2010
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