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Organization

L TATE HAYMON DDS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LEE TATE HAYMON DDS (OWNER)
(910) 738-3913
Entity
Organization

Contact information

Practice address
581 FARRINGDOM ST, LUMBERTON, NC 28358-2614
(910) 738-3913
(910) 738-3994
Mailing address
581 FARRINGDOM ST, LUMBERTON, NC 28358-2614
(910) 738-3913
(910) 738-3994

Taxonomy

Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
6038
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8993728
NC
Enumeration date
03/05/2008
Last updated
03/05/2008
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