Organization
ANTHONY R. IMMEDIATA, D.M.D, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BARBARA SED (OFFICE MANAGER)
(919) 846-5500
Entity
Organization
Contact information
Practice address
7101 CREEDMOOR RD, SUITE 109, RALEIGH, NC 27613-1682
(919) 846-5500
(919) 846-7964
Mailing address
7101 CREEDMOOR RD, SUITE 109, RALEIGH, NC 27613-1682
(919) 846-5500
(919) 846-7964
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
5022
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8994426
—
NC
Enumeration date
10/10/2008
Last updated
12/03/2008
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