Organization
THOMAS M MUSSON DDS,PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS MARCHANT MUSSON DDS (PRESIDENT)
(336) 667-4114
Entity
Organization
Contact information
Practice address
120 WILKESBORO AVE, NORTH WILKESBORO, NC 28659-4218
(336) 667-4114
Mailing address
PO BOX 2062, NORTH WILKESBORO, NC 28659-2062
(336) 667-4114
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
4299
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8996299
—
NC
01
—
96299
NC HEALTH CHOICE
NC
Enumeration date
01/08/2007
Last updated
08/22/2020
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