Individual
DR. JAYNE EBERECHUKWU KALU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
4995 WEDDINGTON ROAD NW, SUITE 40, CONCORD, NC 28027
(704) 918-5560
Mailing address
4995 WEDDINGTON ROAD NW, SUITE 40, CONCORD, NC 28027
(704) 918-5560
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
8195
SC
122300000X
Dentist
Primary
9616
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8195
STATE LICENSE
SC
01
—
9616
STATE LICENSE
NC
01
—
DN1855105
STATE DENTAL LICENSE
MA
Enumeration date
05/18/2009
Last updated
05/31/2017
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