Organization
MARY JO DEXTER,OD,PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARY JO DEXTER MD (OWNER)
(919) 567-1777
Entity
Organization
Contact information
Practice address
102 WHIT CT, ANGIER, NC 27501-5825
(919) 567-1777
(919) 567-9349
Mailing address
102 WHIT CT, ANGIER, NC 27501-5825
(919) 567-1777
(919) 567-9349
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1386
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0921B
BCBS
NC
05
—
890921B
—
NC
Enumeration date
03/05/2007
Last updated
04/20/2008
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