Organization
OLU OYEGUNWA DDS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OLU AYOOLA OYEGUNWA DDS (PRESIDENT)
(910) 484-5141
Entity
Organization
Contact information
Practice address
3416 MELROSE RD, FAYETTEVILLE, NC 28304-1610
(910) 484-5141
Mailing address
3416 MELROSE RD, FAYETTEVILLE, NC 28304-1610
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
9306
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1942561634
—
NC
Enumeration date
12/28/2013
Last updated
12/28/2013
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