Individual
MARY JULIA PREWITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
4140 RAMSEY ST, SUITE 105, FAYETTEVILLE, NC 28311-7672
(910) 488-2292
(910) 488-5751
Mailing address
PO BOX 53662, FAYETTEVILLE, NC 28305-3662
(910) 488-2292
(910) 488-5751
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
5838
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
UC 789774
UNITED CONCORDIA
NC
Enumeration date
08/12/2006
Last updated
07/08/2007
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