Organization
S C TOLBERT DDS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
S C TOLBERT D D S P A (PRESIDENT)
(910) 484-6116
Entity
Organization
Contact information
Practice address
3419 C MELROSE RD, FAYETTEVILLE, NC 28304
(910) 484-6116
(910) 484-5950
Mailing address
3419 C MELROSE RD, FAYETTEVILLE, NC 28304
(910) 484-6116
(910) 484-5950
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
3726
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
015V5
BCBS GROUP
NC
01
—
811969
UNITED CONCORDIA
NC
Enumeration date
05/27/2006
Last updated
05/02/2012
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