Organization
ECU PEDIATRIC DENTAL CLINIC
Active
Parent organization
EAST CAROLINA UNIVERSITY
Organization subpart
Yes
Provider details
NPI number
Legal business name
EAST CAROLINA UNIVERSITY
Authorized official
DR. NICHOLAS BENSON M.D. (VICE DEAN)
(252) 744-7400
Entity
Organization
Contact information
Practice address
2150 HERBERT CT, GREENVILLE, NC 27834-3736
(252) 744-3258
(252) 744-3194
Mailing address
PO BOX 751069, CHARLOTTE, NC 28275-1069
(252) 744-3520
(252) 744-3194
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
0066
NC
1223P0221X
Pediatric Dentistry
Primary
0066
NC
1223P0300X
Periodontics
0066
NC
Other
Enumeration date
07/21/2008
Last updated
01/16/2009
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