Organization
HUSHANG GHODRAT DDS, PA
Active
Other names
Butner Creedmoor Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
JAMIE M. BRUMMITT (OFFICE MANGAER)
(919) 528-9500
Entity
Organization
Contact information
Practice address
2552 CAPITOL DR, SUITE 101, CREEDMOOR, NC 27522-9451
(919) 528-9500
(919) 528-9556
Mailing address
2552 CAPITOL DR, SUITE 101, CREEDMOOR, NC 27522-9451
(919) 528-9500
(919) 528-9556
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6984
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5900569
—
NC
Enumeration date
05/25/2007
Last updated
06/17/2008
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