Organization
TRIANGLE PLASTIC SURGERY CENTER, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LONNIE W BUNN (BUSINESS MANAGER)
(919) 706-4900
Entity
Organization
Contact information
Practice address
9104 FALLS OF NEUSE RD, SUITE 204, RALEIGH, NC 27615-2494
(919) 706-4900
(919) 706-4901
Mailing address
9104 FALLS OF NEUSE RD, SUITE 204, RALEIGH, NC 27615-2494
(919) 706-4900
(919) 706-4901
Taxonomy
Speciality
Code
Description
License number
State
207YS0123X
Facial Plastic Surgery Physician
200900778
NC
208200000X
Plastic Surgery Physician
Primary
2011000555
NC
Other
Enumeration date
01/24/2017
Last updated
01/24/2017
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