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Organization

PRIVATE DIAGNOSTIC CLINIC PLLC

Active
Parent organization
DUKE PEDIATRIC DENTISTRY
Organization subpart
Yes

Provider details

NPI number
Legal business name
DUKE PEDIATRIC DENTISTRY
Authorized official
CHRISTOPHER THOMAS FREDERICK (CFO)
(919) 613-7762
Entity
Organization

Contact information

Practice address
2711 N DUKE ST, SUITE A, DURHAM, NC 27704-2619
(919) 220-1416
Mailing address
PO BOX 110566, DURHAM, NC 27709-5566
(919) 620-4855
(919) 620-4921

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary

Other

Enumeration date
04/21/2010
Last updated
07/11/2022
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