Organization
JAMES A VACCA DDS MSCO PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES ANTHONY VACCA DDS MSC O (PRES)
(704) 872-0969
Entity
Organization
Contact information
Practice address
1316 DAVIE AVE, SUITE C, STATESVILLE, NC 28677
(704) 872-0969
(704) 872-0960
Mailing address
1316 DAVIE AVE, SUITE C, STATESVILLE, NC 28677
(704) 872-0969
(704) 872-0960
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
NC3727
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8998761
—
NC
Enumeration date
05/01/2008
Last updated
05/01/2008
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